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Dysmenorrhea and what are the Other Menstrual Problems

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What is Dysmenorrhea and what are the Other Menstrual Problems?

Dysmenorrhea

Dysmenorrhea refers to the chronic, cyclic pain or discomfort in the pelvic region during a menstrual period.

Other menstrual problems that are faced by women include:

Oligomenorrhea

Menses occurring less frequently than every 35 days. Refer irregular periods

Menorrhagia

Menorrhagia means menstruation occurs at regular cycle intervals but is associated with excessive flow and duration.

Hypomenorrhea

Diminution of the flow or a shortening of the duration of menstruation.

Polymenorrhea (Epimenorrhea)

The shortened menstrual cycles observed more frequently in adolescent and perimenopausal women.

Metrorrhagia

Any acyclic bleeding from the uterus that may be intermittent or continuous and is generally superimposed over a normal menstrual cycle.1

What are the Causes of Dysmenorrhea and the Other Menstrual Problems?

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The exact cause of dysmenorrhea is not known. The changes in concentrations of specific substances known as prostaglandins in the body and the presence of certain underlying disorder have been described to play a role in the pain.

Oligomenorrhea may occur as result of normal variations observed during adolescence or preceding menopause, or due to obesity, stress or increased exercise. It may also be caused due to some underlying disorder.

Menorrhagia and hypomenorrhea occur in association with some underlying pathology. Polymenorrhea has been attributed to the increased function of the ovaries or due to some underlying pelvic disorder. Metrorrhagia in younger women is associated with the hormonal changes occurring at the time of ovulation while in elderly women it needs to be considered seriously, as this is considered as the earliest symptom of cancer.

What are the  Signs and Symptoms of Dysmenorrhea?

Dysmenorrhea is characterized by crampy pelvic pain that begins shortly before or at the onset of menses and lasts for 1–3 days. The pain usually develops within hours of the start of menstruation and peaks during the first or second day of the cycle.

Other symptoms that are commonly observed include

nausea and vomiting

diarrhea

fatigue

fever

headache or lightheadedness.1

In oligomenorrhea, menstruation occurs less frequently than every 35 days.

In menorrhagia, menstruation occurs at regular cycle intervals but is associated with excessive flow and duration.

Hypomenorrhea refers to the diminution of the flow or a shortening of the duration of menstruation.

In case of polymenorrhea, the menstrual cycles are shortened.

Metrorrhagia is characterized by bleeding from the uterus that may be intermittent or continuous and is generally superimposed over a normal menstrual cycle.1

How is it Diagnosed?

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The diagnosis of dysmenorrhea and other menstrual disorders is based on a comprehensive review of the signs and symptoms observed.

The doctor also performs vaginal examination and other investigative procedures based on the history of the condition.

Above tests are usually done to confirm or rule out the presence of any underlying condition that may have lead to the symptoms.

What is the Treatment?

The treatment is mainly based on the presence or absence of any underlying pathology that may have lead to the menstrual disorder. These disorders are managed appropriately either with medications or surgical procedures as required. The medications advised include NSAIDs, oral contraceptives and hormone supplements.

What are the Complications?

The complications associated with the menstrual disorders are usually that caused by the underlying pathology.

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References:

1.Apgar BS. Dysmenorrhea and dysfunctional uterine bleeding. Prim Care. 1997; 24(1): 161–178.