Is called primary dysmenorrhea if not find the underlying cause of secondary dysmenorrhea and if the cause is abnormalities of the womb.
Primary dysmenorrhea is common, probably more than 50% of women experience it and 15% of them experienced severe pain. Primary dysmenorrhea usually arise in adolescence, which is about 2-3 years after the first menstruation.
Pain in primary dysmenorrhea probably derived from uterine contractions stimulated by prostaglandin. Pain is felt more intense when the clot or pieces of tissue from the lining of the uterus through the cervix (neck of the womb), particularly if serviksnya narrow channel.
Other factors that can exacerbates dysmenorrhea are:
- The uterus is covering backwards (retroversi)
- Lack of exercise
- Psychological stress or social stress.
Increased age and pregnancy will cause the disappearance of primary dysmenorrhea. This might be due to cervical nerve degeneration due to aging and loss of nerve at the end of pregnancy.
Differences severity of pain depends on the levels of prostaglandins. Women who experience dysmenorrhea have a prostaglandin levels are 5-13 times higher than women who did not experience dysmenorrhea. Dysmenorrhea is very similar to the pain felt by pregnant women who receive an injection of prostaglandin to induce labor.
Secondary dysmenorrhea are less common and occur in 25% of women who experience dysmenorrhea. Causes of secondary dysmenorrhea are:
- Inflammation of the fallopian tubes
- Abnormal adhesions among organs in the abdomen.
- The use of IUDs.
Secondary dysmenorrhea often begins to rise at the age of 20 years.
Dysmenorrhea causes pain in lower abdomen, which can spread to the lower back and legs. Pain is felt as a cramping of relapsing-remitting or a constant dull pain there.
Usually the pain began to arise shortly before or during menstruation, reaching a peak within 24 hours and after 2 days will disappear. Dysmenorrhea was also often accompanied by headache, nausea, constipation or diarrhea and frequent urination. Sometimes until there is vomiting.
Diagnosis based on symptoms and physical examination.
To relieve pain medication can be given non-steroidal anti-inflammatory (eg ibuprofen, NSAID and mefenamic acid). These drugs are most effective if started drinking 2 days before menstruation and continued until 1-2 days of menstruation.
Besides drugs, pain can also be reduced by:
- Sufficient rest
-Regular exercise (especially walking)
- Orgasm in sexual activity
- Warm compresses on the abdomen.
To overcome the nausea and vomiting can be given anti-nausea drug, but nausea and vomiting usually disappear if cramps been resolved. Symptoms can also be reduced with sufficient rest and exercise regularly.
If the pain continues to be felt and interfere with regular activities, then given a low dose birth control pills containing estrogen and progesterone or given medroxiprogesteron. Giving the two drugs were intended to prevent ovulation (releasing eggs) and reduce the formation of prostaglandins, which in turn wills reduce the severity of dysmenorrhea. If this drug is not effective, then the additional examination (eg laparoscopy).
If very severe dysmenorrhea can be done ablasio endometrium, which is a procedure where the lining of the uterus burned or evaporated by the heater.
Treatment for secondary dysmenorrhea depends on the cause