Period Pain: What is Dysmenorrhea?

By Deepshika Sudhakar and Rajashree Mandaogane

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“What is causing these crazy cramps during my period?”....“Is this normal, do others experience this level of pain too?”.... “Maybe I should see a doctor”....Ever find yourself asking these questions, read along to get a better understanding of the causes and conditions surrounding severe period pain.

The medical term for period pain or cramps is dysmenorrhea. It is classified as primary and secondary dysmenorrhea. In the <insert name/link> blog we went over the biology behind primary dysmenorrhea. The blog explains how hormonal changes lead to painful cramps, and that there is usually no other disorder causing the cramps when it is classified as primary dysmenorrhea.

However if the pain or cramps are caused due to abnormal functioning of the reproductive system, or some disorder, then it is classified as secondary dysmenorrhea. You might have heard the terms “endometriosis” or “PCOS” used in conjunction with period pain. These conditions along with a few others lead to secondary dysmenorrhea. Let’s go over some of these conditions to understand them better.

Endometriosis

Endometriosis is a painful condition, in which the tissue that forms the uterus lining, starts growing outside the uterus. It could grow on the ovaries, bowel, fallopian tubes, behind the uterus and on the bladder. This tissue growing outside the uterus also breaks down and bleeds monthly like the uterine lining. This internal bleeding, which cannot leave the body and remains on site, often results in local inflammatory reactions causing scar tissue formation and adhesions during repair processes. The bleeding, inflammation and scarring all combined can cause a lot of pain.

There are theories about the causes of endometriosis, suggesting that some of the uterine lining tissue that sheds during the menstrual cycle could get backed up into the fallopian tubes and start growing there. However, the exact cause of why the tissue grows outside is still unknown.

Its symptoms include:

• Chronic pelvic pain that increases before or during the menstrual cycle.

• Pain during sex, or bowel movement, depending on where the tissue is growing outside the uterus

• Excessive bleeding

• Fatigue, nausea

PCOS

Polycystic Ovarian Syndrome (PCOS) is a painful disorder caused by an imbalance of reproductive hormones. The hormonal imbalance can interfere with the regular functioning of the ovaries, causing the egg to not get developed or released properly within time. It can also lead to the development of numerous small collections of fluids (cysts) surrounding the egg on the ovaries.

While the exact cause of PCOS is unknown, it is linked to high levels of androgen and insulin. It is also believed that it could be a hereditary condition.

Symptoms include:

• Irregular menstrual cycle

• Excess facial and body hair

• Weight gain

• Thinning hair

• Painful intercourse

Adenomyosis

Adenomyosis is caused when the tissue similar to the uterine lining starts growing in the muscle wall of the uterus. This tissue also undergoes breakdown and bleeding which can lead to an enlarged uterus, and a heavy painful menstrual cycle.

The cause of adenomyosis is not fully understood. Some research suggests that damage to the inner wall of the uterus during pregnancy, labor, delivery or a surgical procedure may cause the abnormal tissue growth.

The symptoms include:

• Abnormal uterine bleeding

• Severe cramping or sharp, knifelike pelvic pain during menstruation

• Lower back/pelvic pain

• Painful intercourse

Uterine Fibroids

Fibroids are benign (non-cancerous) growths of the tissue similar to the uterine lining, but it either grows outside the uterus or on the muscular wall of the uterus. These growths vary in shape, size and location. Fibroids attached to the uterus may twist and cause pain, fever or nausea. These growths could also breakdown and bleed causing pain. Fibroids that are big in size can cause abdominal swelling.

Exact cause of this growth is unknown, there are theories suggesting it could be genetic.

The symptoms include:

• Heavy/prolonged periods

• Bleeding between periods

• Frequent urination

• Enlargement of the abdomen

• Painful intercourse

It is recommended that you see a doctor if you experience any of the symptoms listed for all the conditions above. It is without a doubt sad to see the pain a lot of people with these conditions could be experiencing. It is also sad to see how less research has been done to figure out the exact causes behind these conditions. This is why it is important to talk about them, to take away the stigma and encourage people to study about them.