Menstruation, painful
Alternative names:
cramps, menstrual; dysmenorrhea; painful menstrual periods; periods, menstrual - painful
Definition:
Menstruation that is accompanied by either sharp, intermittent pain or dull, aching pain in the pelvis or lower abdomen.
Considerations:
Painful menstruation affects over half of menstruating women and is the leading cause of lost time from school and work among women of childbearing age. This pain may precede menstruation by several days or may accompany it, and usually subsides as bleeding tapers off.
Some pain during menstruation is normal; excessive pain is not. Dysmenorrhea refers to menstrual pain severe enough to limit normal activities and require medication.
There are several types of dysmenorrhea:
Primary dysmenorrhea refers to menstrual pain that occurs in otherwise healthy women. Prostaglandin activity is thought to be a causative factor because prostaglandin levels have been found to be much higher in women with dysmenorrhea than in women who experience only mild or no menstrual pain.
Secondary dysmenorrhea is menstrual pain that is attributed to some underlying disease process or structural abnormality either within or outside the uterus (for example, pelvic inflammatory disease, fibroids, endometriosis, adhesion, or uterine displacement). Endometriosis is the most common cause of secondary dysmenorrhea and is frequently misdiagnosed as primary dysmenorrhea.
Psychogenic dysmenorrhea may be attributed to emotional stress or true anxiety. It can also be caused by a lack of information regarding menstruation or negative attitudes about the process passed from mother to daughter.
Membranous dysmenorrhea is intense cramping caused by passage of endometrial (uterine lining) tissue being passed through an undilated cervix. This condition is quite rare.
The presence of an IUD (intrauterine device for contraception) may also be a potential cause of menstrual pain.
The incidence of menstrual pain is greatest in women in the late teens and twenties, then declines with age. It does not appear to be affected by childbearing. An estimated 10 to 15% of women experience menstrual pain each month severe enough to prevent normal daily function at school, work, or home. The majority of women will suffer this degree of disability at least once during their reproductive years. Increased risk is associated with younger age, IUD use, multiple sexual partners, and past medical history of any of the conditions associated with secondary dysmenorrhea.
Common causes:
Note: There may be other causes of menstrual pain. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for menstrual pain, occurring alone or in combination with other problems.
|
