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Dysmenorrhea is pain and discomfort experienced just before or during a menstrual period. The pain and cramps experienced are more severe than normal period pain, and can be accompanied by heavy blood loss.
Dysmenorrhea is the medical term given to menstrual cramps experienced in the lower abdomen during or before menstruation. For many, the discomfort is mild but some women have severe cramps which interfere with their day-to-day life.
During female menstruation, hormones trigger the uterus to contract to help with expelling the uterus lining. The hormones involved with this process (called prostaglandis) are also responsible for pain and inflammation - the higher the level of prostaglandis, the more severe the dysmenorrhea.
Uterine muscle contractions constrict blood vessels which usually help to feed the uterus. The resulting pain is comparable with an angina attack whereby the coronary arteries become blocked starving the heart of oxygen.
Dysmenorrhea can also be caused by:
Endometriosis – a condition whereby the lining of the uterus attaches to the fallopian tubes, ovaries or pelvis tissue lining.
Fibroids – uterine fibroids are non-cancerous tumours in the uterus wall.
Adenomyosis – a condition whereby the uterus lining grows outside of the uterus wall
Pelvic inflammatory disease – this is an infection of the reproductive organs and is typically caused by bacteria from sexually transmitted infections (STIs).
Cervical stenosis – the cervix opening can sometimes be too small which restricts blood flow during menstruation and causes painful pressure in the uterus.
For the majority of women, dysmenorrhea is uncomfortable but tolerable while experiencing the menstrual cycle. If your symptoms are severe, or you suspect an underlying disorder, then visit your GP for a proper diagnosis.
To help the GP determine the cause of the problem, they may refer you for a number of diagnostic tests including: ultrasound, CT scan, MRI scan, hysteroscopy and laparoscopy.
Ultrasound – this test uses sound waves to check for problems or abnormalities in the uterus, cervix and fallopian tubes. Most tests are performed against the abdomen but some cases may require a wand to be inserted into the vagina to check the ovaries and uterus lining.
Computerised tomography (CT) – this is a series of cross-sectional images created by X-rays to build an image of the bones and internal organs of the body.
Magnetic resonance imaging (MRI) – a powerful magnetic field and radio waves produce images of the body's internal structure. The scan is painless and can help check for endometriosis or tumours.
Hysteroscopy – a thin tube is inserted into the vagina and through to the uterus. The telescopic tube allows the doctor to check for fibroids or polyps.
Laparoscopy – this is a surgical procedure whereby small incisions are made in the abdomen to allow a fibre-optic tube with a camera on the end to check for conditions such as: endometriosis, ovarian cysts, fibroids, adhesions or ectopic pregnancies.