Painful menstruation or Dysmenorrhea

Dysmenorrhea is also known as painful menstruation or periods, or menstrual cramps, pain during menstruation. There are two types of dysmenorrhea: “primary” and “secondary”.
Painful menstruation

Painful menstruation

Primary dysmenorrhea is the most common kind of dysmenorrhea. Cramping pain in the lower abdomen (belly) can start from 1–2 days before your period begins and can last 2–4 days. Pain can range from mild to severe and can be accompanied by nausea-and-vomiting, fatigue, and even diarrhea. There is no associated pelvic disease. Primary dysmenorrhea is thought to be caused by excessive levels of prostaglandins. The pain subsides on its own once the woman gets pregnant or after delivery. Family history such as mother or sister having similar complaint may be present.
Secondary dysmenorrhea is pain that is caused by a disorder in the woman’s reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection, placement of copper-T. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps.
Endometriosis – this is caused by the cells lining the womb growing in the fallopian tubes or ovaries.  When these cells shed and fall away they cause intense pain.
Adenomyosis – Adenomyosis is a condition in which the cells that line the inside of the uterus (endometrium) are abnormally located in cells that make up the uterine wall (myometrium). This can result in a somewhat enlarged uterus. Adenomyosis can cause very painful menstruation or periods and heavy bleeding.
Uterine fibroids – non-cancerous tumors grow in the womb and can cause heavy and painful periods.
Pelvic inflammatory disease – the womb, fallopian tubes and ovaries become infected with a bacteria which leads to inflammation.  Other symptoms include fever and vaginal discharge.
Symptoms: 
The symptoms of menstrual cramps include:
-Aching pain in the abdomen (Pain can be severe at times.)
-Feeling of pressure in the abdomen
-It may radiate to the thighs and lower back. Pain in the hips, lower back, and inner thighs
When cramps are severe, symptoms may include:
-Upset stomach, sometimes with vomiting
-Loose stools
Diagnosis: Doctor will take the medical history,he/she will take a pelvic examination, and your blood and urine may be tested. A doctor may also wish to use ultrasound exam to get a picture of your internal organs or even use the technique of laparoscopy for a direct look into your uterus.

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