Introduction

• Dysmenorrhoea means pain during menstruation.
• About 60 to 70% of adolescent female have dysmenorrhoea. Most of them have mild symptoms. However, about 25% of them have severe dysmenorrhoea that interferes with their daily activities.
• Dysmenorrhoea can be classified into primary or secondary dysmenorrhoea
• Secondary dysmenorrhoea occurs mostly in adult female in which the pain is associated with an existing condition such as pelvic inflammatory disease (PID) and endometriosis.
• Primary dysmenorrhoea usually occurs in teenagers and usually not associated with any existing medical illness.
• Primary dysmenorrhoea usually occurs 2 to 3 years after menarche (first menstrual flow) and can get worst at the ages between 15 to 25 years old.
• Primary dysmenorrhoea usually becomes less painful as a woman ages and may stop entirely if the woman has a baby.
• Dysmenorrhoea occurs when chemical called prostaglandin is released during menstruation causing the uterus to contract and constricting the blood supply to the endometrial tissue.
• Prostaglandin is produced by the destruction of the endometrial cells (inner layer of the uterus) due to the raised progestrone level during ovulation.

Symptoms

• Symptoms usually occur within 24 hours before menstruation and can last up to 1 to 3 days during menstruation.
• The pain is usually in the lower abdomen and can radiate to the back and thigh.
• Other symptoms include vomiting and diarrhoea.

Diagnosis and treatment

• A diagnosis of primary diarrhoea is made when no underlying illness is causing the pain.
• Primary dysmenorrhoea is treatable with oral contraceptive pill (OCP) and NSAIDS (Non-Steroidal Anti Inflammatory Drugs) such as mefenemic acid (ponstan), ibuprofen and diclofenac sodium (voltaren)
• OCP can stop ovulation and prevent the progestrone hormone to increase. This , in turn can reduce the production of prostaglandin.
• NSAIDS acts by reducing the production of prostaglandin

Self – care tips

• Take NSAIDS immediately when you feel the first signs of dysmenoorhoea and to continue taking it regularly, up to day 5 of menstruation (according to your doctor’s prescription)