What is Dysmenorrhea??
Dysmenorrhea, commonly referred to as ????????? ???? or ??????, is one of the most common gynecological problems worldwide. Despite menstrual pains being highly prevalent among young adolescents, most females suffer in silence and fail to report their symptoms to medical professionals, due to the cultural taboos associated with “the time of the month.”Dysmenorrhea is also the leading cause of recurrent absenteeism from school (5-14%) and work (13-52%) in adolescent females and young women. Not only do these women experience ongoing pain and stress early in life, but it can lead to these women experiencing chronic pain and reduced quality of life as they age.
Dysmenorrhea has been classified as: ??????? ????????????, which is menstrual pain occurring in the lower abdomen before or during the menstrual cycle, in the absence of any other pelvic pathology.
Primary Dysmenorrhea may occur due to diet and lifestyle factors, nutritional and/or hormonal changes, and in teens, who start to experience pain throughout their ovulatory cycle. ????????? ????????????, which is pain associated with secondary pathology, with the onset beginning potentially years after menarche between 20 to 40 years of age. Common causes include:
Endometriosis – When the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
Uterine fibroids or cysts – These noncancerous growths in the wall of the uterus can cause pain.
Adenomyosis – When the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
Pelvic inflammatory disease – This infection of the female reproductive organs is usually caused by sexually transmitted bacteria. Infection can be a side effect of IUDs.
What causes Dysmenorrhea?
Dysmenorrhea is often associated with changes in the hormonal levels in the body during your menstrual cycle. During your menstrual period, your uterus contracts to help expel the uterine lining. Hormone like substances, called prostaglandins, are released, which causes your uterine muscles to contract. It has been proposed with higher levels of prostaglandins that cause uterine contractions, that this causes a reduction of blood flow and causes oxygen deprivation in the uterus, thus leading to menstrual cramps.
Dysmenorrhea is more common among those with heavy periods, irregular periods, whose periods started before twelve years of age, or who have a low body weight.
What are treatment options available for Dysmenorrhea?
Treatment considerations include the use of a heating pack, NSAIDs medication such as ibuprofen, and hormonal birth control.
Other treatment considerations can include, but not exclusive to:
- Vitamin B6 or magnesium supplements may help with the muscle cramps and help relax the uterus
- Acupuncture, which helps to reduce pain and promote smooth movement of blood and energy (also known as Qi).
- Ginger, which is a warming herb that helps to improve circulation and decrease inflammation. Studies show that using ginger a few days before your cycle and a couple of days into it, can decrease pain when compared to NSAIDs.
- Lavender essential oils have been shown in the literature to stimulate the part of the brain responsible for smell, and may release endorphins and serotonin, which leads to increased relaxation and reduction in stress.
- 2 Tablespoons of ground flax seed for the first two weeks of your cycle to support estrogen
- 2 Tablespoons of sesame seeds (or Tahini spread) for the last two weeks of cycle, which helps to supports progesterone
- Fish Oils and Vitamin E supplements have been helpful to reduce period pain intensity when taken together at the beginning of your period.
- Exercise: Reduces pain and prostaglandin synthesis. Studies show that low-intensity exercises such as yoga and stretching help to lower pain during menstrual cycle.
- ?????? ?? ????? (as seen above) is a great exercise for people who are experiencing painful periods, pressure and/or tension on your pelvis. This exercise helps to increase circulation to the pelvic floor and decrease pressure and tension through your pelvis
- ?????? ?????? ????????????? has been shown to be an effective treatment consideration for women in helping them to manage their pain, and associated symptoms. Your Pelvic Health Physiotherapist will perform an assessment of the muscles and connective tissues of your abdomen, pelvic girdle and pelvic floor, in addition to teaching you how to relax these muscles, use deep breathing and other strategies to elicit the relaxation response for stress management purposes.
Contact Foundation Physiotherapy to learn more about treatment options!
Adib Rad, H., Basirat, Z., Bakouei, F., Moghadamnia, A., Khafri, S., & Farhadi Kotenaei, Z. et al. (2018). Effect of Ginger and Novafen on menstrual pain: A cross-over trial. Taiwanese Journal Of Obstetrics And Gynecology, 57(6), 806-809. doi: 10.1016/j.tjog.2018.10.006
Armour, M., Smith, C., Steel, K., & Macmillan, F. (2019). The effectiveness of self-care and lifestyle interventions in primary dysmenorrhea: a systematic review and meta-analysis. BMC Complementary And Alternative Medicine, 19(1). doi: 10.1186/s12906-019-2433-8
Burnett, M., & Lemyre, M. (2017). No. 345-Primary Dysmenorrhea Consensus Guideline. Journal Of Obstetrics And Gynaecology Canada, 39(7), 585-595. doi: 10.1016/j.jogc.2016.12.023
Gerzson, Laís Rodrigues, Padilha, Juliana Falcão, Braz, Melissa Medeiros, & Gasparetto, Andriele. (2014). Physiotherapy in primary dysmenorrhea: literature review. Revista Dor, 15(4), 290-295. https://doi.org/10.5935/1806-0013.20140063
Iacovides, S., Avidon, I., & Baker, F. (2015). What we know about primary dysmenorrhea today: a critical review. Human Reproduction Update, 21(6), 762-778. doi: 10.1093/humupd/dmv039
Matthewman, G., Lee, A., Kaur, J., & Daley, A. (2018). Physical activity for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. American Journal Of Obstetrics And Gynecology, 219(3), 255.e1-255.e20. doi: 10.1016/j.ajog.2018.04.001
Woo, H., Ji, H., Pak, Y., Lee, H., Heo, S., Lee, J., & Park, K. (2018). The efficacy and safety of acupuncture in women with primary dysmenorrhea. Medicine, 97(23), e11007. doi: 10.1097/md.0000000000011007