Sunday, March 11, 2012

Menstrual cramps

How common are menstrual cramps?

Unfortunately, menstrual cramps are quite common. Also known as dysmenorrhea, they often present as throbbing dull pain in the lower part of the abdomen. Most women tend to experience menstrual cramps just a few days before and during the menstrual cycle. In some women, these cramps are a mild annoyance but in others, they can severely affect lifestyle for a few days evert month. The exact number of women who have menstrual cramps is not known because many do not see a healthcare provider-however; the number is believed to be very high.

What other symptoms are associated with menstrual cramps?

Besides the dull crampy lower abdominal pain, menstrual cramps can also be associated with other symptoms. Some women may also complain of lower back pain that may radiate to the back of the thighs and groin. Others may experience nausea, vomiting and loose stools. Sweating is also a common symptom when the cramps are severe. When menstrual cramps are associated with heavy blood loss, women may also complain of dizziness and excessive fatigue. The majority of women have mild to moderate symptoms but some unlucky female does develop the entire range of symptoms.

What causes menstrual cramps?

It is believed that the cramps are due to the uterine contractions. During this time of the cycle, several hormones are released that may also induce pain and trigger muscles contractions of the uterus. Experts believe that the the intense contractions of the uterus narrows the vessels and cut off the blood supply to the uterus- this is often associated with pain-which is very similar to the pain caused during angina.

Are there any disorders that are associated with menstrual cramps?

Yes, several disorders are associated with menstrual cramps. This includes:

Uterine fibroids which are non-cancerous growths in the wall of the uterus. Women who have fibroids often tend to have menstrual cramps

Endometriosis is a painful disorder where the lining of the uterus is implanted outside the uterus. This disorder is associated with severe menstrual cramps

Pelvic inflammatory disease is associated with several sexually transmitted organisms and is also associated with mild to moderate menstrual cramps.

A very rare cause of menstrual cramps is narrowing of the cervix. It may be congenital, induced by trauma or an infection. The condition does require treatment.

Are there any risk factors for menstrual cramps?

Why some women are prone to menstrual cramps is not well understood, however, there are certain risk factors that make it likely that the women may develop menstrual cramps. These factors include:

- young age (less than 20 years)
- Early onset of puberty (usually prior to age 11)
- Having heavy menstrual periods
- Having irregular menstrual cycles
- Having never conceived a baby
- Having a family history of menstrual cramps
- Use of tobacco

What will the doctor want to know if I have menstrual cramps?

When you see your gynecologist, you can expect the doctor to ask you the following questions:

- Description of your symptoms
- Any pain associated with sexual intercourse
- Prior history of any sexually transmitted disease
- Date of your last menstrual period
- What types of medical problems you have
- Any family history of medical problems
- Use of any herbal or prescription medications
- Prior history of child birth, abortions etc

What type of tests are performed when investigating menstrual cramps?

Once your history is reviewed, a pelvic exam is usually done. During the pelvic exam, the doctor may look for any abnormalities of your sexual organs and assess for presence of any infection. Cultures may be obtained. In some cases, the doctor may order the following tests:

Ultrasound uses sound waves to detect any abnormalities. It can visualize problems in the cervix, uterus, ovaries, and fallopian tubes. Ultrasound may be done by placing a probe on the abdomen or inside the vagina.

If the US is not revealing other tests may include a CT scan or an MRI.

In some cases, the doctor may use a lighted camera (hysteroscope) through the vagina to look at the fallopian tubes.

The last test which may be done is to inserted a camera into the abdomen and assess for presence of fibroids, endometriosis, ovarian cysts, or adhesions. It is done under general anesthesia.

How are menstrual cramps treated?

Menstrual cramps are treatable and most women can find effective relief.

The most common drugs are the non-steroidal anti-inflammatory agents. These medications are available over the counter and can help relieve pain.

In women who have irregular cycles, use of oral contraceptive can help reduce the severity of menstrual cramps. There are many types of hormones available, some of which can be injected, others can be applied as a patch on the skin, and in some cases the drugs are delivered via a flexible ring placed in the vagina.

Surgery is the last treatment of choice it may be used in women with fibroids or endometriosis. During surgery, the adhesions are lysed and endometrial implants are removed.

Are there any home remedies for menstrual cramps?

Some women may find pain relief by soaking in a hot tub several times a day. This can be difficult unless one is at home. Others may find relief by applying a heating pad on the lower abdomen or lower back. Rest and avoiding caffeine containing beverages have also been useful in relieving pain in some women.

Are there any alternative medical treatments for menstrual cramps?

Because conventional medicine does not always provide satisfactory pain relief in some women, many have been turning towards alternative medicine.

Exercise of any types is often recommended by alternative practitioners and has been found o provide pain relief. Even walking for 30-40 minutes twice a day has been found to be helpful.

Acupuncture is widely used in the orient to treat a variety of pain disorders. However, multiple sessions are required. Acupuncture is also relatively expensive if one was to undertake the therapy every month.

Transcutaneous electrical nerve stimulation is said to raise the threshold of pain nerves. Some studies suggest that TENS may be effective for menstrual cramps, but this is not a universal finding.

A number of health supplements are recommended for treatment of menstrual cramps. Alternative practitioners recommend omega 3 fatty acids, vitamin B and magnesium supplements. However, there are no clinical trials to validate these claims.

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