Painful
Menses / DYSMENORHEA
Dysmenorrhea is the term used to describe painful menstruation, a condition that
affects a large portion of the female population and virtually incapacitates some.
Of post-pubescent women, 52 percent suffer from dysmenorrhea; of those, 10 percent
find it nearly, if not completely impossible to function for one to three days
each month.
Dysmenorrhea is often confused with PMS. Although both may result in similar symptoms,
the two are distinct and separate conditions. In contrast to sufferers of PMS,
who get some relief with the onset of menstruation, a patient with dysmenorrhea
feels worse once menstruation begins.
Primary dysmenorrhea, one of the two types of the condition, is menstrual pain
in the absence of a pelvic pathological condition.
Secondary dysmenorrhea, in contrast, is the result of such a condition, including
endometrial polyps, pelvic inflammatory disease, endometriosis, or submucous myomas.
In your girls, this type of dysmenorrhea by result from a uterine or vaginal anomaly
with obstruction of menstrual outflow.
SYMPTOMS
Symptoms of dysmenorrhea, which may begin a few hours or days before menstruation
and can last up to two or three days, can include:
- Pain over the lower abdomen, which may radiate to the front of the thighs
- Low back pain
- Nausea
- Diarrhea
- Headache
- Fatigue
- Loss of consciousness (syncope) and collapse
CAUSES
Several theories regarding the cause of dysmenorrhea have been proposed, but no
exact cause has been determined. Complicating matters, its cause may actually
vary among women.
Psychological factors were once believed to be the primary cause of dysmenorrhea.
Studies have failed to support this theory, however. Over the years, medical practitioners
have come to believe that several factors play a role in dysmenorrhea.
Because dysmenorrhea occurs only during ovulatory cycles, the condition may be
related to the release of hormones, such as Vasopressin. Vasopressin causes contractions
of the uterus, which can result in cramps. The hormones estrogen and progesterone
have also been suspected in dysmenorrhea.
Obstruction in the pelvis has also been examined as a cause of menstrual pain.
Such obstruction can lead to retention of menstrual secretion, resulting in irritability
and contractility in the pelvis because of chemicals in the retained fluid. The
nerves in the uterus also may become more sensitized to stimuli.
The most commonly accepted theory involves prostaglandins, natural chemicals that
are released by structures in the ovaries near the time of menstruation. Prostaglandins
increase the activity of the musculature in the uterus, leading to contractions
and cramping, and the obstruction of blood flow in the vessels to the tissue in
the uterus. Pain results when this decreased blood flow causes swelling in the
surrounding tissue.
TREATMENT
Many patients do not report symptoms of dysmenorrhea because they are unaware
that relief from pain is possible. Treatment is available, and has become more
sophisticated and effective as research into causes continues.
Physical therapy offers options preferred by many women because of the non-narcotic
and non-invasive nature of the techniques. Successful treatment options, which
are available at Family Physical Therapy Services, may include:
- Heat packs
- Biofeedback methods
- Relaxation techniques
- TENS (Transcutaneous electrical nerve stimulation)
TENS, for example, is a non-invasive, non-narcotic procedure that has been
used successfully in the control of post-operative pain, low-back pain,
labor and delivery, and numerous other conditions. It is believed that
this method works by causing the release of natural painkillers in the
brain and body.
The physical therapists at Family Physical Therapy Services
have been specifically trained in these treatment options. Your therapist
will develop an individualized program for you, based on an intensive
evaluation.
You can be assured that we at Family Physical Therapy Services
will take your discomfort seriously. With proper treatment, you need not
be disabled by dysmenorrhea.
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