Dysmenorrhea is the pain that some women experience during the days of their period. Sometimes it starts even before the bleeding and is usually more intense on the first day and gradually subsides, but it can last two or three days.
It is considered that 50% of women have dysmenorrhea, being more common among young women. The pain can manifest in the pelvic, lower back or legs and is sometimes accompanied by nausea, vomiting, diarrhea, headache or dizziness.
It can occur in completely healthy women and is due to the synthesis of a chemical called prostaglandin , which accumulates in the endometrial tissue during the ovulatory menstrual cycle. This endometrial tissue is the one that lines the inside of the uterine cavity and is designed to nourish the pregnancy in its early stages. Prostaglandins are responsible for contracting the uterus during the period so that it completely expels the endometrial tissue that has not been useful in the absence of pregnancy. These substances are also responsible for the uterine contractions that occur during childbirth, and is the reason for menstrual pain.
With which we deduce that the period is painful due to a physiological mechanism, that it affects some women more than others, and that intense menstrual pain only occurs in ovulatory cycles . For this reason, periods do not usually hurt adolescents in their first cycles or women who take contraceptives because they prevent ovulation and, therefore, the production of prostaglandins and pain.
When faced with a patient who has painful menses, a good questioning and physical examination must be carried out to rule out pathologies that may be responsible for pain during menses, such as endometriosis or uterine malformations. If it is an essential dysmenorrhea, without added pathology, treatments can be indicated that act in different ways: analgesics or muscle relaxants to relieve uterine contractions (the most common anti-inflammatory drugs, such as ibuprofen or diclofenac, inhibit the synthesis of prostaglandins) or hormonal contraceptives , which are effective in 90% of women, to inhibit ovulation.
Other treatments that have proven to be effective are electrostimulation and acupuncture or digitopuncture.
Other alternatives, which have not provided sufficient scientific evidence, but have been pointed out as mitigating pain are:
- Avoid tobacco and alcoholic beverages.
- Regular physical exercise, because it increases the synthesis of natural endorphins and decreases the production of prostaglandins, and acts as a muscle relaxant.
- Local heat in the pelvis or lower back or massages can also provide relief due to their relaxing effect.
- There are some products on the pharmaceutical market that stimulate cellular cannabinoid receptors and can act as alternative analgesics to the classic ones.
- Certain diets rich in omega 3 fatty acids , present in fish oils, decrease the synthesis of prostaglandins. Magnesium , a mineral found in green leafy vegetables, nuts, seeds, and whole grains. Zinc , vitamin B or infusions of ginger , valerian, cinnamon… can help us cope better with those days if we don’t want to resort to medical treatment.
Faced with severe dysmenorrhea , which makes it impossible to perform usual tasks, a gynecologist should be consulted . He will be the specialist indicated to rule out, identify and treat the possible pathology that is causing the pain and indicate the most appropriate treatment to combat it.
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