Painful menstruation, also known as dysmenorrhea, is one of the top reasons for missed work and school days in the United States. Painful menstruation can be classified as primary or secondary dysmenorrhea. Once the cause of menstrual cramps has been identified, proper treatment can be given to reduce or eliminate pain.
Primary Dysmenorrhea
Primary dysmenorrhea is the most common type of painful menstruation and it is caused by the production of prostaglandins. Prostaglandins are local hormones that line the uterus. Cells that contain prostaglandin receptors work with these local hormones to regulate specific body functions. One of those functions is causing contractions of smooth muscle cells. Because the uterus is composed of smooth muscle, prostaglandins regulate the uterine contractions that push endometrial tissue and blood out of the body during menstruation. When the body produces an excessive amount of prostaglandins, women may experience severe menstrual cramps as well as nausea, vomiting, headaches and diarrhea. Menstrual cramps caused by excessive prostaglandin production can be treated with over-the-counter anti-inflammatory drugs such as ibuprofen and aspirin. More severe cramps can be treated with hormonal birth control. The hormones contained in birth control pills thin the lining of the uterus and reduce prostaglandin production.
Secondary Dysmenorrhea Defined
Secondary dysmenorrhea is less common than primary dysmenorrhea and results from diseases and conditions that affect the reproductive organs. Women who have had normal menstrual periods in the past may begin to experience severe cramps when an abnormality develops in the uterus, fallopian tubes, ovaries or other pelvic organs. Pelvic inflammatory disease (PID), endometriosis, fibroids and cervical stenosis are major causes of secondary dysmenorrhea.
Secondary Dysmenorrhea Causes
PID is a complication of some sexually transmitted diseases. It causes inflammation of the pelvic organs and may also cause difficulty in conceiving children. Endometriosis is the growth of endometrial tissue outside of the uterus. When a woman menstruates, this tissue breaks and bleeds. This can contribute to severe menstrual cramps. Fibroids are benign tumors that are found inside the uterus. Fibroids can bleed, contributing to more severe menstrual cramps and heavier bleeding during the menstrual period. Cervical stenosis is a narrowing of the opening to the uterus. This can cause menstrual cramps because stronger uterine contractions may be needed to expel blood and tissue from the uterus.
