2) Secondary dysmenorrhoea
Secondary dysmenorrhoea can occur at any age in the fertile periods of women (from puberty to menopause). It mostly occurs in adult female due to pelvic diseases which cause pelvic congestion. Secondary dysmenorrhoea is characterised by pain in the affected area and side. It is always relieved by menstrual flow.
- Increased blood supply – which causes congestion of uterus or ovary or pelvis as in the case of inflammatory diseases such as salphingo-oophoritis, parametritis and pelvic adhesions
- Decreased blood supply – which causes cramps of uterus or ovaries
- Heavy blood loss – due to excessive bleeding which in turn reduces the blood supply of the affected part which in turn causes cramps and pain.
- Obstruction -may be due to cervical stenosis or because of abnormal position of uterus or clots or due to cramps.
- Uterus- due to abnormal position (acquired retroverted uterus) Fibroid uterus, endometrial polyp, any abnormalities (like cervical stenosis, endometriosis)
- Ovaries – due to chocolate cysts of ovaries or any other cystic swelling in ovaries. When it is due to ovaries, it usually occurs during ovulation period (14th day or middle of menses) initially and lasts till the end of the menses.
- Pelvic inflammatory diseases with leucorrhoea (white discharges) will usually cause adhesions and abnormalities while healing. And finally foreign substance, IUCD (intra uterine contraceptive device) used for contraception may also be the cause of pain and excess bleeding during periods. If it is the case, it should be removed.
It is often described as labour-like pain with some bearing down sensation in the lower abdomen which may extend to back and legs (mostly felt in front of the thighs). But it varies in nature of pain, places of occurrence and timing. The nature of the pain may be cutting or gripping or colicky or a constant dull ache. Pain usually commences just before the start of menses and it is more on the first day and tapers in the subsequent days. But some may have pain only on the first day and some throughout the periods. Pain will also be more while passing clots. It mostly accompanies with
- Nausea, vomiting and fainting
- Altered bowel habits like diarrhoea or constipation
- Frequent urination
- Premenstrual symptoms like heaviness, fullness and painfulness of breasts or/and abdomen may occur before and during the periods
- Heart palpitation and sweating can also occur due to anxiety and hormonal changes.
- If the painful periods are late and bleeding is heavy – rule out ectopic pregnancy
- If the pain is more just before periods – rule out pelvic diseases
- If the pain is more in the middle of the periods – rule out ovarian complications.
Prevention of dysmenorrhoea
- Stress and strain
- Sedentary life
- Nutritious diet, especially food rich in vitamins A, B, C and E, and magnesium and zinc
- Balanced diet, low in carbohydrates to maintain healthy weight
- Plenty of fluids – water, juices to avoid dehydration
- Regular exercises like walking, jogging or swimming
Management of pain at home
- Rest in a relaxed manner in well-aerated room in a comfortable position (bending double position usually relaxes the abdomen and thus eases the pain)
- Warm drinks which usually clear dizziness and headache
- Light diet to manage nausea and abdominal disturbances
- Warmth application over the painful area which mostly soothes it
- For congestion – Artificial menstruation is induced with hormonal drugs since menses releases the congestion and thus pain
- For inflammation and cramps – Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) are often used. These drugs inhibit prostoglandins which acts as a precursor for congestion and pain
- Oral contraceptive pills are also often used to reduce the pain. It acts hormonally. It prevents ovulation (the release of an egg) and so the preparatory works in endometrium for lodging a fertile egg doesn’t appear. So there won’t be any congestion or pain. Hence, a woman, who does not ovulate, will not experience any spasmodic cramps. This type of treatment induces anovulatory cycles which may cause infertility.
Surgery – In extreme painful cases, it is performed as a last resort for removing ovarian cysts, endometriotic cysts, polyps, adhesions and fibroids. In case of heavy bleeding with bulky uterus and fibroids, hysterectomy (removal of uterus with or without ovaries) is performed. Also, sometimes surgeons perform presacral sympathectomy i.e., cutting away the sensory nerves of the uterus and ovaries to block the conduction of the pain to the brain, but these operations are very rarely performed in very extreme cases. Here the patient won’t feel pain but will have all other symptoms.
Even though nobody thinks of Homeopath in an acute condition of dysmenorrhoea, miraculous cure can be seen in the case of dysmenorrhoea. Treatment with Homeopathic medicines often reveals miracles. Homeopathy can cure the condition rather than control it temporarily. Each system has its own advantage and scope and Homeopathy is no exception. Within its limit, its performance is often wonderful. It treats the patient in whole (mental and physical state of symptoms).
(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)