Understanding Types of Dysmenorrhea and its Symptoms

“Everything else just… fades into the background. There’s just endless pain. I lie in bed awake, sometimes three sometimes till five in the morning. Medications help but only a little. I’m still in my twenties, I don’t want to rely on them so much.” This is the story of Megha and thousands of other women like her around the globe.

Women who go through such unbearable period pain are often thought of as being dramatic is what Mehas’s experience tells us. “I always knew something was not right. I kept telling my father, he said it cannot be bad enough to miss school. So, I went. These were always the times when I missed my mother dearly,” says Megha.

Mensuration cycle or periods occur when the uterus sheds its inner lining once a month to prepare for a possible pregnancy. Women often experience symptoms of periods in the form of mood swings, bloating, back ache, sensitive breasts, painful cramps, etc.

Dysmenorrhea Definition

Dysmenorrhea is the medical term given to painful periods and period cramps.

Over half of the women who menstruate experience period pain in the first three days of their period. The severity of period pain differs for every woman. However, for some women, the pain is so bad that they must skip a few days of regular activities and stay at home. This is not normal.

According to a review published by ‘Epidemiologic Reviews’ in 2014, almost 16-91% of women who menstruate go through dysmenorrhea, with 29% of them experiencing severe pain.

To make things worse, some women may even experience other dysmenorrhea symptoms like nausea, diarrhea, headache and dizziness apart from the period cramps.

In this blog, we’ll go over the two types of dysmenorrhea and their causes and risk factors.

Dysmenorrhea Types

There are two types of dysmenorrhea or period pain: Primary and Secondary.

1. Primary Dysmenorrhea

Primary dysmenorrhea is the cramping pain that occurs as a result of periods alone. They are not caused by any other underlying medical conditions.

When your period begins, your body releases prostaglandins which trigger the shedding of the uterine wall and the contraction of the uterus. These contractions are at their peak during the first two days of your period. But, before your period begins, the progesterone (another hormone) levels drop. This can lead to an increase in prostaglandins before your period begins.

The more prostaglandins, the more the intensity of the uterine contractions, and the severity of the period pain. People with primary dysmenorrhea often experience longer and heavier periods.

Risk factors may contribute to the Primary Dysmenorrhea

Certain risk factors that may contribute to Primary dysmenorrhea include:

• Smoking
• Stress, anxiety or depression
• Excess weight or obesity
• Early puberty (first period before the age of 12)
• A family history of painful periods
• Never having given birth

In many women with primary dysmenorrhea, the periods become less painful as they age, the pain may also improve after giving birth once.

2. Secondary Dysmenorrhea

The scary one of the two dysmenorrhea types. Unlike primary dysmenorrhea, secondary dysmenorrhea occurs as a result of some underlying disorders and conditions. The pain tends to last longer and be more severe. The pain may also gradually worsen as the period continues and might not go away even after the period ends.

Risk factors may contribute to Secondary Dysmenorrhea

As secondary dysmenorrhea occurs due to some underlying conditions, some of the conditions are listed below:

Endometriosis – Endometriosis is a condition in which tissues like the inner lining of the uterus grow outside of the uterus (or womb). These tissues react just like the ones inside the uterus to the hormone called estrogen. During your period days they swell and after contractions bleed. This causes the surrounding tissue to become irritated, inflamed, and swollen.

The breakdown and bleeding of the endometriosis tissue may also cause scar tissues or adhesions to form wherever it’s bleeding. Adhesions can cause organs and different tissues to stick together, causing pain.

• Uterine growths – Uterine growths like fibroids and cysts grow on the outside, inside or on the walls of the uterus. Even though they are unwanted growths, they are harmless and completely unrelated to cancer cells. These uterine growths can cause increased pain during periods, along with abdominal pain, bloating, constipation, and lower back pain.
• Adenomyosis – Adenomyosis occurs when the uterine lining breaks through the muscle walls of the uterus. This causes cramping, pressure in the pelvic and abdominal region, and bloating during periods.
• Pelvic inflammatory disease or PID – PID is an infection of the female reproductive organs. Untreated Sexually Transmitted Diseases (STDs) are the common cause, but they can also stem from other infections.
• Structural difference – Problems or defects with the fallopian tubes, uterus, and other reproductive organs that women are born with can also result in pain during periods.

Dysmenorrhea Symptoms

Symptoms of dysmenorrhea, both primary and secondary, can vary in intensity and duration but often include:

• Severe cramping pain in the lower abdomen, back, or pelvis
• Nausea and vomiting
• Diarrhea or constipation
• Headache
• Fatigue
• Dizziness or fainting
• Sweating
• Irritability or mood swings
• Difficulty concentrating
• Painful bowel movements or urination (in secondary dysmenorrhea)

You can experience the symptoms anytime before or at the onset of menstruation, and the same can last for several days. Sometimes, the severity of dysmenorrhea symptoms can significantly impact daily activities and the quality of your life. Seek medical advice if symptoms are severe or interfere with daily routine.

What Causes Dysmenorrhea?

Understanding what causes dysmenorrhea is crucial for effective management. Seeking medical evaluation can help identify contributing factors and guide appropriate treatment strategies. Here are some common factors that cause dysmenorrhea.

Primary dysmenorrhea:

• Increased levels of prostaglandins cause uterine contractions and pain during menstruation.
• Hormonal changes during the menstrual cycle affect the uterine lining.

Secondary dysmenorrhea:

• Underlying medical conditions such as endometriosis, uterine fibroids, pelvic inflammatory disease (PID), or adenomyosis.
• Structural abnormalities in the uterus or cervix.
• Intrauterine devices (IUDs) as a rare cause.

Other contributing factors:

• Early age of menarche (The first occurrence of menstruation in a woman)
• Heavy menstrual bleeding.
• Smoking
• Stress or anxiety
• Lack of physical activity

How is dysmenorrhea diagnosed?

Dysmenorrhea is typically diagnosed through a combination of medical history, pelvic examination, and possibly imaging tests such as ultrasound or MRI to identify underlying conditions like endometriosis or uterine fibroids. Some additional diagnostic procedures may include:

• Blood tests to check for hormonal imbalances or other underlying conditions.
• Laparoscopy for visual confirmation of endometriosis or other pelvic abnormalities.
• Endometrial biopsy to rule out certain conditions.

Ensure you get a comprehensive evaluation done. This will help your healthcare provider in determining the cause and severity of dysmenorrhea, and to guide you with appropriate treatment plans for symptom relief and management.

Conclusion

Don’t let others convince you into thinking, you are being “dramatic.” Your pain is valid. If it keeps you from doing your daily activities, we suggest paying your ob-gyn a visit. It can be exhausting and bothersome. Exercising, applying heat and adequate sleep can help with mild to moderate period pains.

If your periods have suddenly become heavier, or you’re experiencing pain like you’ve never experienced in your periods earlier, you need to see your ob-gyn.

If you want to know more about the female body and its wonders, see you again here!

FAQs

1. Is having dysmenorrhea normal?

Yes, dysmenorrhea, or painful menstruation, is common, affecting many women during their menstrual cycles. However, if you face severe and unbearable period pain, seek medical attention.

2. How do I tell the difference between normal cramps and dysmenorrhea?

Normal menstrual cramps are typically mild to moderate and are often relieved by over-the-counter medications and home remedies. Dysmenorrhea involves severe, unbearable period pain that interferes with daily activities and may require medical intervention.

3. What are the risk factors for dysmenorrhea?

Risk factors for dysmenorrhea include young age, heavy menstrual flow, smoking, family history, early puberty, and certain reproductive conditions like endometriosis or uterine fibroids.

4. How does secondary dysmenorrhea cause menstrual cramps?

Secondary dysmenorrhea is caused by underlying conditions such as endometriosis, uterine fibroids, pelvic inflammatory disease, or adenomyosis. These conditions can lead to inflammation, tissue growth, or structural abnormalities, resulting in more severe and persistent menstrual cramps compared to primary dysmenorrhea. Read the blog to find out more.