Bringing on board one of the most common problem faced by all the ladies at one point of time or another.

    • So, is it really that common ?
    • Is there a need to know if the pain is usual or to be alarmed about ?
    • And what can you do resort to for the relief of pain ?

So here, let’s tackle all of them one by one.

Menstrual pains occur is about 70% teenagers and 30-50% menstruating women.
They can be of 2 types :

      • One that is begins a few hours before or just after onset of menstrual periods and last for 48-72 hrs
      • Second type where pain begins several days before menstrual flow and persists until a few days after stopping of bleeding – this is the type you need to be alarmed about.

This could be due to causes like :

      • Pelvic inflammatory disease
      • Fibroids
      • Polyps
      • Cervical stenosis
      • Congenital malformation of uterus
      • IUCD ( intrauterine contraceptive device)
      • Endometriosis
      • Adenomyosis

Why the pain?

Basically, in a normal cycle, the uterus lining thickens in preparation for pregnancy incase it occurs.
If you get pregnant, this lining remains and supports pregnancy.
If not, after your ovulation time when the ovum or eggs are not fertilized, this uterus lining sheds off and releases a substance called prostaglandin which makes your uterus contract.
This contraction inturn constrict the blood supply to tissues in uterus and thereby uterus squeezes out the dead uterus lining of uterus with each contraction.
This is what you experience as painful cramps during your periods.

When to seek help?

      • painful periods > 3months causing absenteeism from school/work/ hindrance in daily work
      • cramping pain with nausea
      • pain without periods
      • fever, headache, diarrhea

Home treatments-

      • heating pad on abdomen or back
      • massaging abdomen
      • warm bath
      • light nutritious meals
      • reduce intake of salt, alcohol, caffeine
      • Vit E 200mg 1-0-1  ( starting 2 days prior and 3 days during periods)

Treatments-

      • Analgesics- paracetamol 500mg 1-1-1
      • Antispasmodics- hyoscine( buscopan)1-1-1
      • Drotaverine (drotin) 1-1-1
      • NSAIDs- mefenamic acid 250-500mg 1-1-1-1 provides relief in 80-90%
      • Indomethacin  25mg 3-6 times a day- relief 70% cases
      • Ketoprofen 50mg 1-1-1 successful 90% cases

In case you want contraception along with relief of your menstrual cramps,
several options are available on advice of your doctor depending on what might suit you best :

      • Like oral contraceptive pills ( regularizes periods+ contraception+ reduces bleeding)
      • Progesterone containing IUCD (Mirena/Progestasert- relieves pain + contraception)

If not relieved with medical options, evaluation is needed to find the pathology causing it.

Surgical options-

      • Diagnostic hysteroscopy
      • Diagnostic laparoscopy and treatment of causative factors
      • Hysterectomy in elder women- as last resort
      • Transcutaneous electrical nerve stimulation- effective in 45% cases

So, hopefully this helps you to tackle your menstrual cramps better now.

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