Uncovering the intricacies behind dysmenorrhea (painful periods) reveals a shared experience that transcends age, ethnicity, and background. This seemingly common condition affects an estimated 3/4 individuals that were assigned female at birth, emphasizing the need for a compassionate and informed discussion surrounding its impact on daily life and supportive treatment options. In this blog post, we delve into the different facets of dysmenorrhea, exploring its prevalence, types of dysmenorrhea, and natural evidence-based treatment options.
Understanding Dysmenorrhea:
Dysmenorrhea can be categorized into two main types: primary and secondary. Primary dysmenorrhea manifests as cramping pelvic pain before or during menstruation, lasting between 8 to 72 hours. Factors such as smoking, longer or heavier periods, positive family history for dysmenorrhea, and pelvic inflammatory disease contribute to its risk. On the other hand, secondary dysmenorrhea is associated with identifiable causes, including endometriosis, PCOS, fibroids, adenomyosis, uterine infections and other causes. Dysmenorrhea can also be categorized by severity: mild, moderate or severe.
The Impact on Daily Life:
Severe dysmenorrhea can extend beyond physical discomfort, and can negatively impact personal, educational, and work-related aspects of life. It ranks as a leading cause of short-term absenteeism from work or school. Furthermore, it can raise the risk of developing other chronic pain conditions (more information on this further in down in this blog post), creating a ripple effect that can affect overall well-being.
Exploring the Underlying Causes:
The physiological cause of dysmenorrhea lies in increased contractions of the uterine muscular wall (myometrium) and elevated prostaglandin levels, which can be due to fluctuations in levels of sex hormones (estrogen and progesterone). The increase in prostaglandins (cyclic fatty acids that can varying hormone-like activity) sensitize nerve endings leading to pain and can also cause vasoconstriction, contributing to venous congestion.
Seeking Further Assessment:
It's crucial to recognize when dysmenorrhea warrants further investigation. Progressive worsening of pain, abnormal vaginal bleeding, pain with intercourse (dyspareunia), changes in vaginal discharge, or inadequate relief from over-the-counter pain medications are strong signs that suggest further assessment should be done to help identify potential causes for the pain.
Comprehensive Treatment Approaches:
Non-pharmacological interventions play a pivotal role in managing dysmenorrhea. For secondary dysmenorrhea, treatment options vary based on the underlying cause. For example, specific antioxidants have demonstrated efficacy in reducing pelvic pain due to endometriosis.
Ginger, renowned for its anti-inflammatory properties, has shown efficacy in reducing menstrual pain as well. Traditionally, ginger is also used as a circulatory stimulant. Another benefit of ginger is it has remarkable anti-nausea and anti-vomiting activity and can be particularly beneficial for individuals that experience these symptoms during menses.
Increased physical activity has also demonstrated reduction in chronic pelvic pain. Physical activity can help increase blood flow, increase release of endorphins and helps to reduce stress. 45-60 mins of physical activity 3 or more times a week has been shown to help reduce dysmenorrhea.
Local heat applications (heating pad or patch) on the lower abdomen can also help reduce dysmenorrhea as it helps to increase blood flow and improves tissue oxygenation. Limited research found that heat applications were as effective as ibuprofen, superior to Tylenol and superior to no intervention when compared to the control group in reducing menstrual pain.
Transcutaneous electrical nerve stimulation (TENS) has also demonstrated efficacy superior to a placebo treatment for the reduction of dysmenorrhea.
Acupuncture has also been shown to help reduce menstrual pain. Laser acupuncture may be particularly beneficial for dysmenorrhea caused by certain conditions, such as, endometriosis.
There are also several pharmacological treatment options (hormone or anti-inflammatory medications) that should be discussed with your healthcare provider to determine benefits and risks.
This article is being shared as educational content and is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healthcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance and supervision.