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Painful menstruation? See a doctor


… experts say it’ts a medical condition that requires treatment

Recent studies have revealed that about 50 per cent of women above the puberty age suffer from a monthly disorder known as primary dysmenorrhoea. Such disorders have been found to be intense in some that it often interrupts their daily activities. Consequently, as much as 65 percent of work or school days are lost by these women in a year.
Experts define dysmenorrhoea as a difficult or painful monthly flow. However, it could either be primary or secondary. In primary dysmenorrhoea, there is often no identifiable cause while in secondary, an undelying pathological state is present. Hence, secondary dysmenorrhoea could be due to inflammation of the reprodutive organs, cyst or intrauterine device and such conditions are corrected when the underlying cause is removed. However, the focus here is primary dysmenorrhoea since the population of women affected with it is far higher than those with secondary dysmenorrhoea.
According to experts, the biochemical agent responsible for primary dysmenorrhoea is known as prostaglandin. These are metabolically active unsaturated fatty acids generally produced by cell membranes of different cells of the body and of the endometrial tissues of the female reproductive system. It could be problematic as with the case of primary dysmenorrhoea when it is available in such an enormous quantity. Hence, women suffering from primary dysmenorrhoea often have almost two to ten folds of the prostaglandins level compared to those without primary dysmenorrhoea.
Prostaglandins as an agent of primary dysmenorrhoea is produced during the later stage of the menstrual cycle. It is stimulated by the drop in progesterone level (one of the hormones responsible for the normal reproductive development in women) during this period such that the amount produced should be enough to cause contraction and shedding of the endometrium which is observed as menstruation. However, in primary dysmenorrhoea, the amount produced is so much that rather than causing the shedding of the endometrium alone, it has a significant effect leading to hypercontratility of the uterus, uterine ischemia (reduced blood flow) and a painful sensation.
Therefore, in women with primary dysmenorrhoea, the available prostaglandin is so enormous that it presents a monthly painful disorder experienced during the monthly menses. It has however been observed that in patients with primary dysmenorrhoea, this painful episode occurs some few months after their menstruation and at most, two years later, leading to to a belief that it is a psychological problem associated with adolescence in women.
Until recently, doctors say management of painful menstruation was mainly the use of home remedies including recommendations that such women should return to bed early enough, drinking of alcohol and various other means, which yielded little or no benefits.
Experts say women experiencing painful menstruation should first realise that it is a medical condition which requires treatment. Thus, if your period pains are mot relieved by simple pain killers, you need to see a doctor, preferably, a gynaecologust. The doctor may perform a pelvic examination to rule out any underlying conditions that can cause dysmenorrhoea.
Medical treatment include the use of non-steriodal anti-Inflammatory drugs (NSAIDs) and also the contraceptive pill. By preventing ovulation, the contraceptive pill reduces the production of prostaglandins and pain.
Pharmacists say NSAIDs have potent anti-inflammatory, nalgesic and anti-pyretic agents. They have been used extensively in the treatment of arthritis that they are believed to be sole agent in the treatments of arthritis, osteoarthritis and various other inflammatory responses. These class of drugs have also been found to be useful in the management of primary dysmenorrhoea.
When given as a single daily dose, NSAIDs such as piroxican could prevent the occurrence of painful menstruation, especially if administered 24 hours before the start of the regular monthly flow. According to experts, if the pain does not subside after taking this type of drug in correct doses, it is expected that such a patient visit a physician or gynaecologust for proper diagnosis in case there is an incidence of secondary dysmenorrhoea for which complete pelvic examination is positive.
Other group of drugs used in the management of primary dysmenorrhoea, according to doctors who spoke to NHO, includes spasmolytics like Buscopan and analgesics like paracetamol among others.
What is known however, is that primary dysmenorrhoea is a medical condition and women don’t have to be embarrassed discussing it with their doctors. Indeed, it is only the doctor that can determine whether the pain is due to primary or secondary dysmenorrhoea and depending on the type, would be able to recommend an effective drug that provides rapid relief when primary dysmenorrhoea comes knocking!

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