Women's Health

Those painful cramps

Written by Mark Abell

The development of cramps during the menstrual period (called dysmenorrhea) is probably the most common of all gynecological disorders - it affects up to fifty percent of all postpubertal women. For many reasons, dysmenorrhea is often separated into two classifications, primary and secondary, depending upon its cause.

Primary dysmenorrhea (cramps during the menstrual period) occurs only during the ovulatory phase; in other words, it occurs only during the time in which the female is ovulating, generally about the fourteenth day of the cycle. The reason for the pain is the same reason for almost all pain - the release of proteins in the body called prostaglandins. In this case, the release of prostaglandins causes a contraction of the uterine muscles, which produces pain. This release of prostaglandins also causes the menstruation. The actual "reason" for the pain is that the contraction of the muscles in the uterus causes "ischemia" - a lack of oxygen to tissue - which always produces a painful response. There are "classic" associated symptoms of dysmenorrhea - and I am sure most have heard (and experienced) them - they include nausea, diarrhea, headache, and emotional changes.

Secondary dysmenorrhea is a more pronounced pain and is associated with a pathologic cause for the pain rather than physiologic, as in primary dysmenorrhea. The most common cause of secondary dysmenorrhea is endometriosis, which is when there is "endometrial" tissue found within the abdominal cavity (not where it should be). Other possible causes of secondary dysmenorrhea include pelvic inflammatory disease (infection of the female organs, usually indicative of sexual transmitted disease), or congenital (innate, born with) problems associated with the female organs.

The treatment for dysmenorrhea is often extremely straightforward. Since the introduction of the NSAIDS (non-steroidal anti-inflammatory drugs), the use of Ibuprofen has been the mainstay of treatment for cramping in women during the menstrual cycles. There are a number of different NSAIDS available, and, for the most part, they all work in the same way, so don't believe all of the hoopla on television. What you need is a drug to stop the production of prostaglandins, which is what the non-steroidal drugs do. By preventing the production of prostaglandins, one is stopping the pain. If a dose is needed, the best (and most correct) way of taking medicines such as Ibuprofen (Motrin), Advil, Aleve, etc., is to take them three times a day with food. These medications often last only 6 to 8 hours. If the administration of non-steroidal anti-inflammatory medications do not work to relieve the pain (and there is not a secondary reason for the pain), then sometimes the addition of ! an o ral contraceptive (birth control pill) is warranted. The birth control pill helps with the pain (in addition to the pain medications) by inhibiting ovulation. It is best, however, to check with your physician before trying any of the additional methods. And, as in all situations, always check with your pharmacist when adding medications if you already take any other forms of medications.

If one suspects that their pain is from a different source than merely physiologic changes, it is extremely important to seek the attention of a family physician or even a specialist. Don't just keep treating the pain; there very well could be a logical (and treatable) reason for the continued pain and most often, early detection is more than just a plus when it comes down to selecting and initiating a treatment program.

There is an excellent and informative web page which helps define menstrual cramps and dysmenorrhea; take a look at it:

http//www.saonet.ucla.edu/healthed/HANDOUTS/CRAMPS/HTM

I performed other searches of the topic on the internet, revealing the following sites; it might behoove the reader to visit some of them:

http://www.healthwire.com/women/ask/dysmenra.htm

http://www.hsv.tis.net/dymedias/a/accm/DYSMENN.HTM

Furthermore, there are literally hundreds of other web sites available on the internet for review.

I searched the web using Infoseek, and the term "dysmenorrhea", resulting in well over a hundred different sites. Take a look for yourself.

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