Dysmenorrhea or menstrual cramps are painful cramps that come just before or during the menstrual period . About 50 % of women during their reproductive period have had different degrees of dysmenorrhea ,some time or the other .

What causes menstrual cramps ?

During the menstrual period there is release of some chemicals called prostaglandins which are produced in the lining of the uterus . These cause contractions of the muscle layer of the uterus and its blood vessels causing pain in the abdomen , back or thighs .

How severe is dysmenorrhea ?

For some women , it is just mild , for others it is so severe that it causes disruption of normal everyday activities and lifestyle .

What are the types of dysmenorrhea?

Technically there are 2 types of dysmenorrhea – primary and secondary . Primary amenorrhea is the uterine spasm that I’ve described above . It recurs in every menstrual period and is not associated with any reproductive organ disease .Secondary dysmenorrhea is secondary to some disease in the reproductive organs like Endometriosis , adenomyosis, fibroids , pelvic inflammatory disease , congenital defects of the uterus , fallopian tubes , vagina or an imperforate hymen .

Secondary dysmenorrhea starts much before a menstrual period , is more intense and lasts much longer than 1 or 2 days from the start of the period .

Are menstrual cramps just painful cramps ?

No, sometimes they are associated with headache, nausea, vomiting , diarrhoea and dizziness.

When should you meet a doctor ?

If dysmenorrhea is quite severe and affects your life and day to day activities during the time of your menstrual periods or it lasts much longer than them please meet your doctor . They will take a complete history , examine you and order an ultrasound – pelvic or trans vaginal . If there are some abnormal pathologies in the reproductive organs ,they may also do a diagnostic or corrective laparoscopy .

How are painful periods treated ?

Painkillers like NSAIDs -some like Meftal spas , Combiflam , ibuprofen etc are available over the counter . These reduce the prostaglandins and hence the intensity of cramps.
Using a hot water bottle or a thermal pad over the lower abdomen may help.
For more severe cases hormone pills like oral contraceptive pills , patches , implants , vaginal rings and intrauterine devices ( IUDs) may help.
Surgery like laparoscopic treatment of endometriosis, fibroids , adhesions may also be needed in patients who do not respond to medical treatment. Hysterectomy to take care of adenomyosis may also be recommended. However , remember , surgery is generally a last resort.

Are there any alternate therapies to take care of menstrual cramps ?

Acupressure , acupuncture , physical therapies that ease trigger points for pain may be helpful .

How can menstrual cramps be reduced ?

Regular exercise most days of the week produces chemicals which block prostaglandins which cause menstrual cramps. Aerobic exercises like walking , running , swimming , cycling help. Making exercise a way of life definitely has its perks, taking care of dysmenorrhea being one of them.
Using heat pads and hot water bottles on the lower abdomen
Adequate sleep and relaxation in the form of yoga and meditation also help to alleviate pain to a certain degree.
Avoid caffeine containing beverages , alcohol and smoking

So remember , you don’t have to suffer this pain silently. If it affects your lifestyle or is intense , take stock and talk to your doctor right away . There’s definitely help on the way.

A question often asked is why normal delivery ?

Let me explain the reasons why .

A normal vaginal delivery is one where you deliver through the vagina . This delivery could follow a spontaneous onset of labour or an induced one .

Spontaneous onset of labour means that you go into labour without any artificial means or medication at 37-42 weeks of pregnancy and induced labour means that medication is used to bring on labour pains . A delivery could also be assisted delivery using vacuum or forceps .

Why normal delivery ?

First and foremost , because nature intended it this way .

Labour pains no doubt are very intense but there are ways of relieving those to a large extent using methods like epidural analgesia or entonox or N2O gas inhalation which eases pain .

There is less blood loss , chances of infection and no anesthesia complications like those in a caesarean delivery .

Recovery is faster and hospital stay too . You are discharged within 1-2 days of a normal delivery compared to a caesarean section .

Skin to skin contact with your baby and breast feeding can also be initiated earlier.

Why is a normal delivery more beneficial for your baby ?

As the baby goes down the tight birth canal , fluid from the chest and lungs are squeezed out and this reduces respiratory issues .

The baby also acquires more good bacteria from the vagina thus gaining better immunity for life due to this micro biome .

And as already stated , you can begin bonding with your baby earlier ; breast feeding is also initiated earlier compared to a caesarean delivery .

Pregnancy and delivery is a life changing event that comes with its share of joy, positivity and fears . Every delivery is different and so it is best to chalk out a birth plan with your doctor and to allay whatever anxiety or apprehensions you may have . Also remember that labour is a very fluid process and during its course ,should problems arise , you must be prepared with plan B as well .

Engage a birth partner like your husband , mother , mother in law in these deliberations with your doctor and look towards a happy and healthy beginning of a lifetime of motherhood !

It’s OK to feel apprehensive but go into labour , more empowered and informed .

Posts tagged gynecologist

Menstrual cramps – What you should know