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Don't put up with it

UMA KRISHNASWAMY

Dysmenorrhoea is a common and an eminently treatable problem.

DYSMENORRHOEA, or period pains, affects almost all women at some point in their reproductive lives. The intensity of the pain can vary from experiencing mild discomfort to a pain severe enough to interfere with day-to-day activities. Fortunately, the latter form affects only a minority of women.

Dysmenorrhoea may be of two varieties:

Primary, where there is no apparent cause for pain and

Secondary, where the uterus is affected by common problems like endometriosis, fibroids, etc.

The cause of primary dysmenorrhoea is still poorly understood. During mensturation, the uterus contracts to shed its lining. An exaggeration of this contraction is thought to be responsible for the pain.

Complex chemicals called prostaglandins are responsible for this exaggerated muscle activity in the uterus.

Factors such as a lack of exercise or emotional stress may aggravate the problem.

Pain usually affects the woman just before or after the onset of the periods and usually lasts a day. In the severe form, it may last several days.

The pain may be felt low down in the abdomen, but there may also be discomfort in the lower back, legs, etc.

In some instances, there may also be a headache, a bout of nausea, vomiting, dizziness, upset in bowel function, etc.

Most women with dysmenorrhoea will respond well to simple treatment. This may include:

  • Rest (both mental and physical) during the acute phase of pain

  • Warm or tepid bath

  • Hot water bottles placed over the abdomen or lower back

  • Relaxation techniques: deep breathing, yoga etc.

  • Mild pain killers such as paracetamol

  • Improving general health by regular exercise

    More severe instances of dysmenorrhoea will require a thorough assessment by a gynaecologist who will carry out a physical examination and an ultrasound scan of the uterus.

    Prostaglandin inhibiting drugs, oral contraceptive pills to suppress ovulation (and hence pain) may be prescribed in such instances where there is no response to the methods listed earlier.

    It must however be pointed out that most so called instances of "severe" dysmenorrhoea, unresponsive to simple pain killers, is due to a failure to administer a pain killer early enough or in adequate doses. In secondary dysmenorrhoea, surgery may be required.

    In India, traditionally, dysmenorrhoea is seldom treated with any degree of sympathy either by family members, employers, school or college authorities or by the medical profession in general. The prevailing socio-cultural attitude is that "if one is born a woman, one must put up with pain". It is important for women to be aware that not only is dysmenorrhoea a common problem, but it is also an eminently treatable problem and there is no reason for women today to "put up" with any thing, most of all pain.

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