Menstrual Disorders: Dysmenorrhea

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  • 0:01 Dysmenorrhea
  • 1:19 Symptoms
  • 2:04 Causes
  • 3:51 Types
  • 5:46 Treatment
  • 7:01 Lesson Summary
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Instructor: Rebecca Gillaspy

Dr. Gillaspy has taught health science at University of Phoenix and Ashford University and has a degree from Palmer College of Chiropractic.

For some women, their monthly menstrual cycle is accompanied by painful cramps. This condition is referred to as dysmenorrhea. Learn what causes dysmenorrhea, what makes the symptoms worse and what treatment options are available in this lesson.

Dysmenorrhea

Women are given the exclusive blessing of being able to become pregnant and carry a child. This blessing comes with what some woman consider a curse - I'm talking about the monthly menstrual cycle. Each month the lining of a woman's uterus builds up as it prepares for the arrival of a fertilized egg. If no fertilization, and therefore no pregnancy, occurs then the uterus sheds the built-up tissues.

For some of the women of reproductive age this monthly process goes on without a hitch, but for others the process brings painful menstrual cramps, a condition referred to as dysmenorrhea. Dysmenorrhea sounds like one of those complicated medical terms, but you can recall it fairly easily if you break it down. For instance, the prefix 'dys' means difficult, and the latter part of the word, 'menorrhea,' sounds the same as menstrual cycle, so dysmenorrhea is simply a difficult menstrual cycle. You might be wondering what causes this condition and why is it so bad in some women? Well, these are questions we will explore in this lesson.

Symptoms

Pain that comes around at the same time as a woman's monthly cycle or period is not uncommon, but it can vary in intensity from one woman to the next. Some women may experience mild symptoms that amount to nothing more than some discomfort or a feeling of heaviness in the lower abdomen. Others may experience moderate to severe symptoms that last up to a few days and interfere with the woman's ability to perform normal daily activities, like going to school or work. These symptoms include sharp lower abdominal pains that come and go in waves, as well as lower back pain, headaches, nausea and possibly constipation or diarrhea.

Causes

So, what causes all this pain and discomfort and why do some women have to endure it every month? Well, remember when we talked about the uterus shedding built-up tissue each month if there's no fertilized egg? When this tissue breaks down it releases prostaglandins, which are hormone-like substances that promote uterine contractions. They occur naturally in a woman's body, but prostaglandins can also be given as a medication to a woman in labor to increase uterine contractions and help the birthing process along.

So in pregnant women, prostaglandins help deliver the baby. Whereas in a woman who is not pregnant, they encourage the contractions that help expel the old uterine lining out of the uterus and through the cervix, which is the doorway out of the uterus. In fact, it's thought that women who have a narrow cervical canal or elevated prostaglandin levels may be prone to more severe menstrual pain due to the added pressure and intensity.

As all of this is going on leukotrienes, which are substances that encourage an inflammatory response, are also produced. It might help you recall this term if you remember that the prefix 'leuko' refers to white or white blood cells, which are the cells that are called on when there's an inflammation to fight and the suffix 'trienes' sounds like 'trying,' as if the leukotrienes are trying to call the white blood cells by causing an inflammation. So, we can summarize the causes of dysmenorrhea as the uterine contractions spurred on by the prostaglandins, coupled with the inflammation spurred on by the leukotrienes.

Types

There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea is described as painful menstrual cramps that begin within the first year of menstruation that are unrelated to an underlying condition. The term 'primary' is often used to describe something that happens early, much like we might think of elementary school as primary school, so you can use this fact to help recall the early onset of this type. With the primary type there's no underlying problem with the reproductive system, but there may be contributing factors, such as stress, poor diet and a lack of exercise that worsens the symptoms.

Secondary dysmenorrhea is described as painful menstrual cramps related to an underlying condition. If something is secondary, it typically comes after, which is what we see with the onset of secondary dysmenorrhea, as it tends to develop later, after a woman has experienced normal cycles.

The key difference is that with secondary dysmenorrhea, there's an underlying condition that is exacerbating the pain and discomfort. This could include a number of reproductive disorders, but commonly involves endometriosis, which is a condition in which tissues of the uterine lining develop outside the uterus. It's as if the normal tissues from the lining of the uterus, known as the endometrium, get lost and start to develop elsewhere in the pelvis.

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