Let’s learn what exactly is dysmenorrhoea..??
Primary or Physiological dysmenorrhoea
Dysmenorrhoea is painful menstruation of magnitude sufficient enough to incapacitate day-to-day activities.
It is usually confined to teenagers and adolescents where there is no identifiable pathology.
How is an adolescent or physiological dysmenorrhoea examined in clinical practice?
Here are a few signs to study to differentiate or identify a physiological dysmenorrhoea-
1)Mostly confined to adolescents
2)Almost always confined to ovulatory cycles.
3)Pain is usually cured following pregnancy and vaginal delivery.
4)Pain related to dysrhythmic uterine contractions and uterine hypoxia.
CAUSES OF PAIN-
1)Due to tension and anxiety during adolescence.
2)Lower pain threshold is often attributed as an aggravating factor.
3)Stenosis i.e narrowing of either an internal os or cervical canal.
4)Unequal development of uterus from Mullerian ducts during embryonic development.
5)Disturbance in autonomic nervous control of the uterine muscle.
6)Increased secretion of pain-causing hormones like prostaglandins, progesterone, endothelins which increase myometrial activity directly.
Physiological dysmenorrhoea usually disappears within 2 years of menarche.
The pain begins a few hours before or just with the onset of menstruation which may last for 24-48 hours. The Pain is usually spasmodic and confined to the lower abdomen, lower back and medial aspects of thighs. It may be associated with systemic discomfort like nausea, vomiting, fatigue, diarrhoea, headache. Rare cases endure complaints like pallor, cold sweats and fainting.
Treatment usually aims at reducing pain severity by giving drugs from groups like fenamate, propionic acid derivatives and indomethacin.
Surgical intervention is needed only when drug therapy fails.
Secondary or pathological dysmenorrhoea
When menstrual pain is associated with identifiable pelvic pathology… it’s a secondary dysmenorrhoea.
– No pelvic pathology on laparoscopic or usg examination
-pelvic pathology present
The causes of pathological dysmenorrhoea could be Chronic pelvic infection, pelvic endometriosis, pelvic adhesions, adenomyosis, uterine fibroid, endometrial polyp, IUCD in utero, pelvic congestion.
When it comes to Homoeopathy, it has best to offer for physiological dysmenorrhoea.
The Homoeopathic approach is subtle, gentle, soothing and has no side effects. It lowers anxiety and treats individuals in a holistic way.
Dr Monali Shah. ( BHMS and Dietician )