DYSMENORRHEA (Menstrual Cramps)
DYSMENORRHEA (Menstrual Cramps)
Dysmenorrhea refers to severe, painful cramps during menstruation. Primary dysmenorrhea means pain has recurred regularly since periods began. Secondary dysmenorrhea means pain began years after periods started. Females with dysmenorrhea are generally fertile -- cramps indicate that ovulation occurred 12 to 14 days earlier. Dysmenorrhea usually is less severe after a woman has a baby. The female reproductive system, especially the uterus is involved. Dysmenorrhea can affect females after puberty.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Psychotherapy or counseling, if your daughter's dysmenorrhea is stress-related.
SIGNS & SYMPTOMSCramping and sometimes sharp pains in the lower abdomen, lower back, and thighs.
Nausea and vomiting (sometimes).
Lack of energy.
Severity of symptoms varies greatly from one female to another, and from one time to the next in the same person.
CAUSESStrong or prolonged contractions of the muscular wall of the uterus. These may be caused by concentration of prostaglandins (hormones manufactured by the body). Research shows that females with dysmenorrhea produce and excrete more prostaglandins than those who don't have as much discomfort.
Dilation of the cervix to allow passage of blood clots from the uterus to the vagina.
Organic causes include:
-- Pelvic infections.
-- Endometriosis, especially if dysmenorrhea begins after age 20.
-- Benign tumors of the uterus.
-- Poor posture.
-- An underdeveloped uterus.
RISK FACTORSUse of caffeine.
Stress. The degree of dysmenorrhea may vary according to your daughter's general health or mental state. While emotional or psychological factors don't cause the pain, they can worsen pain or cause some females to be less responsive to treatment.
PREVENTING COMPLICATIONS OR RECURRENCEYour daughter can take female hormones that prevent ovulation, such as oral contraceptives.
Your own observation of symptoms.
Medical history and physical exam--including a pelvic examination--by a doctor.
POSSIBLE COMPLICATIONSSevere pain that regularly interferes with your daughter's normal activities.
Your daughter's symptoms can be controlled with treatment.
Heat helps relieve pain. Your daughter should use a heating pad or hot-water bottle on her abdomen or back, or she should take hot baths. She can sit in a tub of hot water for 10 to 15 minutes as often as necessary.
See Appendix 19 for suggestions to help your daughter reduce stress.
MEDICATIONFor minor discomfort, use non-prescription drugs such as acetaminophen.
Your doctor may prescribe:
-- Anti-prostaglandins, including non-steroidal, anti-inflammatory drugs.
-- Oral contraceptives, which prohibit ovulation.
See Medications section for information regarding medicines your doctor may prescribe.
No restrictions. When resting in bed, your daughter should elevate her feet or bend her knees and lie on her side if it makes her feel more comfortable.
DIET & FLUIDS
No special diet. Your doctor may prescribe vitamin B supplements for your daughter. These help relieve symptoms sometimes.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your daughter has symptoms of dysmenorrhea that she cannot control by herself.
Your daughter's menstrual bleeding becomes excessive (she saturates a pad or tampon more frequently than once each hour).
Your daughter develops signs of infection, such as fever, a general ill feeling, headache, dizziness, or muscle aches.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.