Dysmenorrhoea is a gynaecological problem that's characterised by severe pain during menstruation. The pain is severe enough to have an impact on lifestyle and everyday activities, such as working, exercising or looking after your children, and the symptoms of dysmenorrhoea can remain the same or progressively worsen over time.  Here's an overview of the causes, symptoms, diagnosis and treatment approach for dysmenorrhoea:

Causes And Symptoms

Dysmenorrhoea can occur if you have higher than normal levels of prostaglandins, which play a role in how your uterus contracts during menstruation. High levels of these substances, which behave much in the same way as hormones do, can cause uterine cramping as a result of increasing the speed and number of contractions in the uterus as the womb lining is shed. Dysmenorrhoea can also occur as a result of an underlying health condition that affects the uterus, such as fibroids, pelvic inflammatory disease or endometriosis.

Aside from severe, painful pelvic cramps, symptoms of dysmenorrhoea can include lower back pain, headaches and nausea. Some women also experience a continuous, dull pelvic pain alongside bouts of the sharp pain associated with cramps. Additionally, you may experience loose or more frequent bowel movements due to increased pelvic pressure.

Diagnosis And Treatment Approach

To diagnose dysmenorrhoea your doctor will take details of your symptoms and carry out a pelvic exam to check for signs of an infection or structural abnormalities in your reproductive organs. Blood tests will be carried out to check hormone levels and establish your blood's inflammatory markers are raised, which indicates the presence of an infection. You may also be referred for diagnostic imaging, such as an ultrasound or MRI scan, to check for signs of an underlying condition.

Treatment for dysmenorrhoea is dependent on the established cause. Your gynaecologist may recommend hormonal birth control to prevent ovulation and stop you menstruating. If you don't want to use birth control, you may be prescribed nonsteroidal anti-inflammatories and pain relief drugs that are only used just before and during menstruation. If an underlying condition is causing dysmenorrhoea, you may require surgery to get relief from your symptoms. For example, scar tissue and cysts caused by endometriosis will have to be removed to resolve your painful periods. Additionally, regardless of the cause of dysmenorrhoea, a hysterectomy can be carried out to resolve your symptoms. The uterus is removed during this procedure, so you will have to be sure you don't want to have any biological children in the future.    

It can be uncomfortable to talk about menstruation, but it's important to establish the cause of your painful periods. If you're experiencing the symptoms associated with dysmenorrhoea, don't suffer in silence. Schedule an appointment with your gynaecologist to get a formal diagnosis and establish a treatment plan.