Dysmenorrhea Treatment in Delhi, India

There are two types of dysmenorrhea which are as follows:

• Primary dysmenorrhea refers to recurrent menstrual cramps that happen repeatedly and is not associated with any other disease. The initial episode of pain begins a couple of days before the onset of the period or when the bleeding takes place. It is characterised by pain in the lower abdomen, low back ache and pain in both thighs and legs.
• Secondary dysmenorrhea refers to menstrual cramps that occur due to any disorder or infection in the reproductive system. Here, the pain develops during the onset of the menstrual cycle and lasts longer than primary dysmenorrhea. Various conditions that include muscle cramps are as follows:
• Pelvic Inflammatory Disease: This occurs due to an infection caused by bacteria in the uterus that spreads to other surrounding organs. This is followed by pain in the abdomen or during intercourse.
• Endometriosis: This is a painful condition characterised by pain, swelling and scarring of the uterus. In endometriosis, the endometrium (the lining of the uterus) is found outside the uterus.
• Adenomyosis: This is a painful condition where the inner lining of the uterus consequently grows into the muscle of the uterus. As a result, the uterus's size becomes more prominent than usual and causes pain and abnormal bleeding.
• Uterine Fibroids: These are non-cancerous tumours which grow in or on the uterus. It causes menstrual bleeding, back pain, frequent micturition (urination) and pain during sexual intercourse.
• Cervical stenosis: It refers to a narrowing of the cervix or opening to the uterus.
  
  

The following are the symptoms associated with menstrual cramps:

• Severe abdominal pain
• Cramps in the lower abdomen
• Low backache
• Pain in the back of thighs
• Nausea
• Vomiting
• Fatigue
• Diarrhoea
• Headache
• Fainting
  
  

If the menstrual cramps last for more than three days, it is recommended to consult a doctor. The doctor evaluates medical history, examines the patient and accordingly performs the following tests to diagnose dysmenorrhea:

• Pelvic Examination: This is carried out with the help of an instrument called a speculum to examine the vagina, cervix and uterus for any lumps. A small amount of vaginal fluid can also be taken for further testing.
• Ultrasound: This is performed to look for the status of the uterus, cervix, fallopian tubes and ovaries.
• Laparoscopy: It helps to detect underlying conditions like endometriosis, fibroids, ovarian cysts, adhesions and ectopic pregnancy. During this procedure, the surgeon makes small, multiple incisions in the abdomen with the help of a fibre optic tube containing a small lens to look for reproductive organs.
• Imaging tests like CT scans or MRIs provide more detailed information about the female reproductive organs.
• Hysteroscopy- This is carried out with the help of an instrument called a hysteroscope, which provides a visual examination of the cervix and inside the uterus.

Before initiating treatment for this condition, several factors must be considered. These are:

• Age of the patient
• Overall health
• Cause of the condition
• The extent of the condition
• Tolerance for specific medicines
  
  

Treatment comprises of:

• Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen
• Oral contraceptives
• Dietary modifications include an increase in the consumption of proteins and reducing sugar and caffeine
• Vitamin supplements
• Hot fomentation on the back or thighs
• Adequate rest
• Avoid smoking and drinking alcohol
• Endometrial ablation
• Endometrial resection
• Surgical removal of the uterus if having associated conditions like fibroids
• Breathing exercises
• Acupuncture

Factors that increase the risk of developing dysmenorrhea include:

• Obesity
• Smoking
• Consuming alcohol
• Starting menstruation before the age of 11

Dysmenorrhea doesn't cause any complications as such. However, this condition may hinder personal as well as professional life. Apart from this, certain conditions associated with menstrual cramps result in complications like endometriosis and fertility issues.