Gynecology And Obstetrics-

Pain during menstruation

Synonyms

Dysmenorrhea; Menstrual pain

definition

Young women in particular often experience cramping pain during their period.

The term "menstrual pain" (pain during menstruation / period) is understood to mean the occurrence of mild to severe, pulling abdominal pain that occurs during the rejection of the uterine lining.

introduction

Pain during menstruation is more likely to suffer very young women. Especially with young girls who are getting their period for the first time, it can occur during rejection of the Uterine lining severe discomfort occurs.

In general, one should expect any kind of pain during menstruation / period to visit Specialist in gynecology (Gynecologist) justify. In most cases, however, no identifiable cause can be found for the onset of pain during menstruation / period. In medicine, it is rather assumed that period pain is a phenomenon that mainly affects young women and disappears as they grow up.

Despite this assumption, young women suffering from severe menstrual pain should not simply put up with this phenomenon. Pain during menstruation / period can in many cases already be made easier by using it Home remedies be alleviated. If you have severe pain during your menstruation / period Painkiller (Analgesics) help to provide relief to the women affected.

backgrounds

Pain during menstruation / period shows up in most cases labor-like, cramp-like pains that occur in the area of the lower abdomen. In many of the women affected, the symptoms even radiate into the lower back out.

Typically, the pain symptoms already begin a few days before the menstrual period starts. Most of the time, the pain during menstruation / period lasts approximately three to four days on.Only in rare cases are the symptoms so severe that the women affected can no longer perform everyday tasks. In addition to the pain during menstruation / period, many women suffer from other symptoms such as:

a headache
diarrhea
nausea and Vomit

Period pain can be divided medically into two classes (primary and secondary period pain).

Primary pain during menstruation / period

This form of menstrual pain is characterized by the fact that the symptoms are already a few days before the start of your menstrual period occur. In most cases, the symptoms do not resolve as you get older. Many women are up to menopause (last menstrual period in a woman's life) accompanied by primary pain during menstruation / period. A pathological physical cause for the occurrence of the symptoms can usually not be found in these cases. The direct reason for the development of primary period pain is due to Prostaglandins (Tissue hormones) triggered spasms of the uterine muscles and the accompanying detachment of the Uterine lining.

Secondary pain during menstruation / period

Secondary menstrual pain typically occurs first from the age of 30 or 40 on. Various gynecological diseases are the direct cause of this type of pain during menstruation / period. Solve in most cases scattered cells of the uterine lining, Polyps or inflammatory processes in the area of the fallopian tubes secondary menstrual pain.

frequency

Menstruation / period pain is not uncommon. Every woman experiences moderate to severe pain during menstruation at least once in her lifetime. It is even assumed that approximately 30 to 50 percent of women suffer from regular menstrual discomfort. The so-called "Endometriosis“(Disintegration of uterine lining cells) is the most common cause of secondary menstrual pain.

Causes and accompanying symptoms

Primary pain during menstruation / period

Primary menstrual pain is mainly due to hormonal influences triggered. During the cycle, the Mucous membrane inside the uterus steadily on around for the potential reception of a fertilized egg to be prepared. If the mature egg is not fertilized within the fallopian tube, the thickened one must Uterine lining be repelled at the end of the cycle.

The female sex hormone is primarily responsible for this rejection reaction estrogen responsible. This hormone induces the secretion of the tissue hormone prostaglandin within the female organism, which, in addition to its role in initiating inflammatory reactions, is also responsible for the mediation of pain stimuli and the contraction of the uterus responsible for. In many women this tissue hormone is involved in the development of primary pain during menstruation / period. In everyday clinical practice, several factors can be determined that increase the likelihood of primary pain occurring during menstruation / period.

To the most common risk factors counting:

an early onset of the first menstrual period (around the age of 12)
low body weight (BMI < 20)
known period pain in close female family members
particularly long menstrual cycles

It is also assumed that psychological factors how Anxiety or stress favor the occurrence of primary pain during menstruation / period.

Secondary pain during menstruation / period

Secondary pain during the menstrual period is always based on organic diseases that require gynecological clarification and prompt treatment. One of the most common causes of secondary menstrual pain is Endometriosis. In this disease, individual cells from the lining of the uterus are scattered around the body. In most cases, mucous membrane cells in the abdomen and pelvis can be detected in the affected women. The scattered endometrial cells can also be influenced by the same hormonal changes at these abnormal locations. So it comes from the influence of Estrogen and progesterone also to induce small bleeding and contractions. A crucial indication of the presence of endometriosis are severe pain during menstruation and discomfort during intercourse. Further notes are Deviations from the normal cycle and recurrent spotting.

Also Fibroids and Polyps are among the most common causes of secondary pain during menstruation / period. It is about benign ulcers in the muscles of the uterus and the cervix.

In addition, you can malignant changes (tumors) lead to secondary pain during menstruation / period. In the early stages, malignant tumors of the female genital organs (especially in the area of the cervix and ovaries) usually grow unnoticed. Pain is rather untypical for the early stages of the disease. Initial indications of the presence of malignant changes can be long-lasting, unusually heavy bleeding be. Also the appearance of brownish discharge after menopause should be interpreted as a warning and lead to a timely visit to the gynecologist.

Also include inflammatory processes in the area of the female genital organs is one of the most common causes of secondary pain during menstruation / period. In this context it can be observed that above all ascending vaginal infections (Colpitis) to chronic inflammation of the fallopian tubes and thus lead to secondary pain during menstruation / period. The symptoms typically already occur in the affected patients during ovulation on.

Ultimately, secondary pain during menstruation / period can also go through Contraceptives caused (see also Abdominal pain from pill). In this context, the intrauterine coil a high priority.

diagnosis

If a woman experiences recurrent and / or particularly severe pain during her menstruation / period, she should urgently consult a gynecologist. In many cases, the symptoms can be alleviated in the long term after a successful diagnosis. The most important step in diagnosing menstruation / period pain is this detailed doctor-patient conversation (anamnese) in which the quality and location as well as the symptoms accompanying the pain should be shown. In addition, the doctor-patient conversation serves to uncover certain risk factors in the personal and family anamnesis. This conversation is usually followed by a gynecological examination. During this examination, the attending gynecologist tries to rule out possible physical illnesses that could be responsible for the occurrence of pain during menstruation / period. In particular, the mucous membranes, the vagina, the uterus and the ovaries are examined during this examination. In addition, the fit of this contraceptive should be checked in patients with IUDs. Depending on the findings, further examinations should then be carried out. One of the most common tests for women with pain during menstruation / period is to do a Blood test, one Ultrasound examination and / or one Laparoscopy (laparoscopy).

In the case of endometriosis, the diagnosis is often very complicated. The reason for this is the fact that mainly small foci of the blasted off Uterine lining not always easy to find. If there is a clear suspicion of endometriosis, you can imaging procedures (Magnetic resonance imaging; MRI) help to secure the diagnosis.

therapy

In some cases, the pill can relieve the symptoms.

Primary pain during menstruation / period

In most cases, primary menstrual pain does not need to be treated at all. However, if women suffer from severe discomfort during menstruation, various symptoms can occur Painkiller (Analgesics) may be used. Especially those active ingredients belonging to the group of Non-steroidal anti-inflammatory drugs (NSAIDs; NSAIDs) are particularly suitable for treating primary pain during menstruation / period. The pain relievers most commonly used in this context have the active ingredient Ibuprofen. These drugs work through one Inhibition of the formation of prostaglandins and thus over a Decrease in the contractions of the uterine muscles. Medicines are also suitable Paracetamol-based especially good for treating primary menstrual pain. It can also be used for severe pain during menstruation / period antispasmodic drugs can be used. There has been good experience in this area with the application of Antispasmodics like butlyscopolamine (Buscopan), which one Relaxation of the uterine muscles and thus provides relief from menstrual pain.

Also hormonal drugs like that pill can help to significantly reduce primary pain during menstruation / period.

In the case of mild to moderate pain, simple changes in behavior can help improve the woman's wellbeing. Pain that may occur during menstruation Move targeted treatment. The reason for this is the fact that the pain-inducing contractions of the uterine muscles with a Reduced blood flow accompanied. In this way the perception of pain is increased. Gentle sports like Yoga, walking or cycling increase the blood flow to the uterus and thus counteract the development of pain. The use of Hot water bottles is found beneficial by many of the women who suffer from menstrual pain. The cramped uterine muscles are relaxed and the symptoms are relieved by the direct action of heat on the lower abdomen.

Especially young women who suffer from severe pain during their period should consider taking hormonal contraceptives (such as the pill). The artificially supplied Hormones have an inhibiting effect on the expansion potential of the Uterine lining during the cycle. In this way, less mucous membrane has to be shed during the menstrual period. The menstrual period is significantly weaker and the pain also decreases noticeably in intensity. In many cases, the use of hormonal contraceptives can even relieve women of menstrual pain entirely. In everyday clinical practice, the active ingredient chlormadinone acetate (short: CMA) is particularly suitable for women who suffer from severe menstrual pain.

In addition, nature has some miracle cures for menstrual cramps. Especially with infusions yarrow, Chaste tree, Johannis herbs or Lemon balm can help to significantly alleviate the symptoms. However, women who take the pill should note in this context that oral use of St. John's wort can negatively affect the effectiveness of hormonal contraceptives. For this reason, affected women should rather use yarrow, monk's pepper or lemon balm.

Another simple way to relieve menstrual pain is by doing a Acupressure. Pressing an acupressure point that roughly a hand's width below the navel can alleviate uncomfortable menstrual cramps.

Secondary pain during menstruation / period

For secondary menstrual pain, treatment depends on the underlying condition.