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Dysmenorrhea - Causes, Symptoms, Treatment, Diagnosis .
By Research Staff

More than half of all girls and women suffer from dysmenorrhea (cramps), a dull or throbbing pain that usually centers in the lower mid-abdomen, radiating toward the lower back or thighs. Menstruating women of any age can experience cramps.
While the pain may be only mild for some women, others experience severe discomfort that can significantly interfere with everyday activities for several days each month.

The main symptom of dysmenorrhea is pain. It occurs in your lower abdomen during menstruation and may also be felt in your hips, lower back, or thighs. Other symptoms may include nausea, vomiting, diarrhea, lightheadedness, or general achiness.
For most women, the pain usually starts shortly before or during their menstrual period, peaks after 24 hours, and subsides after 2 to 3 days. Sometimes clots or pieces of bloody tissue from the lining of the uterus are expelled from the uterus, causing pain.
Dysmenorrhea pain may be spasmodic (sharp pelvic cramps at the start of menstrual flow) or congestive (deep, dull ache). The symptoms of secondary dysmenorrhea often start sooner in the menstrual cycle than those of primary dysmenorrhea, and usually last longer.

One probable cause of primary dysmenorrhea is attributed to excessive levels of prostaglandins. At the beginning of the menstrual cycle, the endometrium thickens to prepare for pregnancy. When there is no conception, the built-up uterine tissue is shed through menstruation, and prostaglandins are released due to the destruction of the endometrial cells. These hormones, responsible for pains response, cause the uterus to contract and discomfort occurs in the form of menstrual cramps. The excess in prostaglandins could also lead to a longer duration and increased severity of pain.
Other medical issues that can cause primary dysmenorrhea include a retroverted uterus (a uterus that tilts backward) and instances when the cervical canal is considerably narrow, inhibiting the release of endometrial tissue.
A woman’s lifestyle also contributes to the occurrence of primary dysmenorrhea. Unhealthy conditions and practices such as being overweight, lack of physical exercise, stressful activity, smoking, and alcohol consumption are common factors.
On the other hand, secondary dysmenorrhea can be caused by the following medical conditions: ovarian tumors, infection of the fallopian tubes, endomentriosis, sexually-transmitted infections, fibroids, adenomyosis, hormonal imbalance, imperforated hymen, and vaginal septum. And actions such as the use of intrauterine device and other invasive birth control methods as well as internal scarring can also cause menstrual pain.

Treatment for dysmenorrhoea aims to relieve pain or symptoms either by affecting the physiological mechanisms behind menstrual pain (such as prostaglandin production) or by relieving symptoms. Treatments such as paracetamol, aspirin, and NSAIDs work by reducing the activity of cyclo-oxgenase pathways, thus inhibiting prostaglandin production.w8 Treatments such as oral contraceptives work by inhibiting ovulation.