Definition: Menstrual cramps or dysmenorrhoea is intermittent or spasmodic pain in the lower abdomen and back occurring during menses or three to five days before the blood flow starts. It is seen in about half of adult females but may become severe in about 10 % of females. Pain may be associated with vomiting, constipation, feeling of heaviness in abdomen or faintness.
In more than 90 % cases of pain in young girls which occurs on the first 2 or 3 days of menses there may be no definite cause. This pain is normal and has no effect on future fertility. Rarely there may be tightness or obstruction at the cervix i.e. opening of the uterus. Intrauterine contraceptive devices like Copper-T can lead to increase in uterine cramps.
Severe premenstrual and menstrual pain may be seen in cases of
- Fibroids in uterus
- Infection in tubes & ovaries
- Pelvic adhesions
- Uterine anomalies
Gynaecological check-up and ultrasound is done in married women complaining of severe dysmenorrhoea. In unmarried girls a general check-up and abdominal ultrasound is required so as to rule out some serious pelvic disease. In a few cases of severe and gradually increasing pain, laparoscopy may have to be done.
Explanations of the menstrual process, sex education and reassurance to young patients is required
Spasmodic dysmenorrhoea is usually relieved after pregnancy and becomes less severe with increasing age.
Analgesics and antispasmodic drugs should be taken after consulting the doctors.
Oral contraceptive drugs decrease the pain and may be taken. In married women these also provide contraception.
Specific therapy is required in organic causes like fibroids or endometriosis.
Avoidance of a sedentary and highly stressed out lifestyle in young women can help in decreasing the severity of dysmenorrhoea.
A nourishing diet, correction of constipation and regular physical exercise are helpful in all cases.