Dysmenorrhea is painful menstruation.
Dysmenorrhea may be-
1) Primary
2) Secondary
PRIMARY DYSMENORRHEA
Here there is no identifiable cause and using oral contraceptive pills and non-steroidal anti-inflammatory drugs there is a marked relief of the symptom. Primary dysmenorrhoea is usually confined to the adolescent girls, and it appears within two years of menarche, it is more common for girls from affluent society.
Causes of pain -
Mostly confined to the adolescents.
Almost always confined to ovulatory cycles.
The pain is usually cured following pregnancy and vaginal delivery.
The pain is related to uterine contractions and uterine hypoxia.
- Psychosomatic factor
Tension and anxiety during adolescence, lower the pain threshold.
-Uterine muscle hyperactivity has been observed for the case of primary dysmenorrhea.
-Role of prostaglandins
Either due to the increased production of prostaglandins, or increased sensitivity of the myometrium to the normal production of prostaglandins, there is increased myometrium contraction.
- Role of hormone vasopressin
There is increased vasopressin release during menstruation in women with primary dysmenorrhea.
So many other theories also there.
Clinical features
The pain begins a few hours before or just with the onset of menstruation. The severity of pain lasts for few hours may extend to 24 hours or beyond 48 hours.
The pain is spasmodic and may confine to the lower abdomen, may radiate to the back and medial aspect of thighs.
Systemic discomforts include nausea, vomiting, fatigue, diarrhoea headache and tachycardia and may be accompanied by cold sweats, pallor and occasional fainting.
SECONDARY DYSMENORRHEA
Secondary dysmenorrhea occurs due to the pelvic pathology. The patients' suffering is in the age group of thirties.
Causes of pain
It may be due to the increased tension in the pelvic tissues due to the premenstrual pelvic congestion or increased vascularity in the pelvic organs.
Causes of secondary dysmenorrhea
cervical narrowing
chronic pelvic infection
pelvic endometriosis
pelvic adhesions
uterine fibroid
endometrial polyp
Clinical features
The pain is dull, and is in the back and front without radiation. It usually appears 3-5 days prior to the period and relives with the start of bleeding.
The patients may get some discomfort even in between periods.
PREMENSTRUAL SYNDROME
Psychological, neurological, hormonal factor is responsible for this. It often occurs just prior to menstruation. There is a cyclic appearance of the large number of symptoms during the last 7-10 days of menstrual cycle.
Criteria for PMS-
Not related to any organic lesions.
It regularly occurs during the luteal phase of each ovulatory cycle.
Symptoms must be severe enough to disturb the life-style of the women, or she requires medical help.
Symptom-free period during rest of the cycle.
CLINICAL FEATURES
abdominal bloating
breast tenderness
swelling of the extremities
weight gain
irritability
depression
anxiety
fear
tension
confusion
anger
restlessness
forgetfulness
increased appetite
fatigue
tiredness
insomnia
dyspareunia
Homeopathic treatment
Dysmenorrhea and Premenstrual syndrome is really a nuisance to the female community. It is especially true for the working class females and students. The work tension is one of the main factors behind it. Homeopathic medicines work wonders in the treatment of both conditions. With homeopathic medicines, the results are quick and permanent. After a few months of treatment the complaints can be controlled permanently.
The acute episodes of pain are controlled by medicines like Puls, Mag phos, Colcynthis, etc., and the permanent cure is based on the mental and physical aspect with the help of family history and past history of the patient. Usual remedies to prevent recurrence are Medorrhinum, Pulsatilla in high potency, Natrum mur etc.
