It is a medical condition characterized by severe uterine pain during menstruation. The pain is so severe as to limit normal activities or require medication.
There are two types of Dysmenorrhoea: It is one where there is no identifiable pelvic pathology is present. The incidence of sufficient magnitude with incapacitation is about 5-10%. It occurs in the first few years after menarche and affects up to 50% of post pubescent females. The pain caused by excessive secretion of prostaglandins. Prostaglandins are the hormones secreted by the cells in the uterus. These hormones are responsible for the contraction of uterine muscles. When the uterine muscles contract, they constrict the blood supply to the tissue of the endometrium, which, in turn, breaks down and dies. These uterine contractions continue as they squeeze the old, dead endometrial tissue through the cervix and out of the body through the vagina. These contractions, and the resulting temporary oxygen deprivation to nearby tissues, are responsible for the pain or "cramps" experienced during menstruation. 1.It is predominantly belongs to adolescents girls, usually appears within 2 years of menarche. 1.No tests are specific to the diagnosis of primary dysmenorrhoea. Diagnosis is made based on clinical findings. Most of the conventional modes of treatment aim to palliate the pain rather than curing the cause behind it. Secondary dysmenorrhoea is defined as menstrual pain resulting from anatomic and/or macroscopic pelvic pathology. A number of factors may be involved in the pathogenesis of secondary dysmenorrhoea. The following pelvic pathologies can lead to the condition: Types
1.Primary dysmenorrhoea refers to menstrual pain that occurs in otherwise healthy women. This type of pain is not related to any specific problems with the uterus or other pelvic organs.
2.Secondary: Secondary dysmenorrhoea is menstrual pain that is attributed to some underlying disease process or structural abnormality either within or outside the uterus.
3.Membranous dysmenorrhoea
4.Ovarian dysmenorrhoea
1.Primary Dysmenorrhoea
Causes
It has also been attributed to behavioral and psychological factors. The incidence is higher amongst affluent introspective and neurotic women. Those having a low threshold for pain and predisposed to undue fears and anxiety are most susceptible. Although these factors have not been convincingly demonstrated to be causative, they should be considered if medical treatment fails.
Some abnormal anatomical and functional aspects of uterus like stenosis of internal os, unequal development of mullerian ducts causes unequal contraction of uterine muscles, inappropriate law of polarity and imbalance autonomic nervous control.Clinical features
2.The pain begins with the onset of menstruation (or just shortly before) and persists throughout the first 1-2 days, usual duration of 48-72 hours.
3.The pain is described as spasmodic, cramping and superimposed over a background of constant lower abdominal pain, which radiates to the back or anterior and/or medial thigh. Affected women experience sharp, intermittent spasms of pain, usually centred in the hypogastrium or suprapubic area.
4.Other symptoms may include nausea and vomiting, diarrhea, headache, fainting, and fatigue.
5.Symptoms of dysmenorrhoea often begin immediately following ovulation and can last until the end of menstruation.Investigation:
2.The following can be performed to exclude organic causes of dysmenorrhoea:
a.Cervical culture to exclude sexually transmitted diseases
b.Complete blood count
c.WBC count to exclude infection
d.Human chorionic gonadotropin level to exclude ectopic pregnancy
e.Cancer antigen 125 (CA-125) assay: This has limited clinical value in evaluating women with dysmenorrhoea because of its relatively low negative predictive value.
f.Urine analysis
g.Erythrocyte sedimentation rate (While nonspecific, erythrocyte sedimentation rate can help the physician to identify the patient with subacute salpingitis.)
h.Stool guaiac Treatment
Homoeopathy- Homeopathy being an individualistic science tries to find an individual remedy for each case. Different females suffering from dysmenorrhoea present with different symptoms regarding the character, localization, extension and severity of pain.
The character of blood, its color, presence or absence of clots, the underlying cause like fibroids, cysts, endometriosis etc differentiate one case from another. Most importantly the disposition and mental state of each person is different. Hence a Homeopathic remedy is selected by considering the physical, mental and emotional state of each person in order to cure safely and effectively.
2.Secondary dysmenorrhoea
Causes: