Dysmenorrhea, defined as painful cramps that occur with menstruation, is the most common gynecological problem in women of all ages and races, and one of the most common causes of pelvic pain.

Symptoms typically begin in adolescence and may lead to school and work absenteeism, as well as limitations on social, academic, and sports activities.

Symptoms of Dysmenorrhea

1. Pain in the lower back and lower abdomen may also spread to the legs. The pain may come and go or be present as a dull constant ache.
2. Dysmenorrhea may also be associated with headaches.
3. If the pain is very severe, it can cause fainting.
4. Nausea, vomiting may accompany.
5. Digestive disturbances like diarrhea or constipation may be associated.
6. Premenstrual symptoms like bloating and breast tenderness may be present.

Tests are done for Dysmenorrhea

1. Detailed medical history is taken by the doctor.
2. A pelvic examination is done. A pelvic examination is a physical examination done by a Gynecologist through the vaginal opening to assess the female genital organs (vulva, vagina, cervix, uterus, and the adnexa -ovary, and tubes).
3. Ultrasonography of the pelvis to rule out or pick up any underlying conditions is recommended.
4. Laparoscopy, in severe cases where the cause is not identified, may be necessary for the diagnosis (an instrument called a laparoscopy is inserted through a keyhole incision to look at the abdominal organs).

Managing Dysmenorrhea

Painful periods can be distressful for women impacting them not only physically but emotionally and occupationally. Tackling it involves solutions combining lifestyle modification and appropriate medicines.

Diet

1. Avoid foods that cause bloating and water retention, such as fatty foods, aerated drinks, salty foods, canned foods, fried foods, and dairy products.
2. Avoid a diet of refined carbs like sugar, bread, and pasta.
3. Caffeine (contained in tea, coffee, chocolate, energy drinks, etc.) may make period pain worse and these foods are best avoided.
4. Hydrate well. Have lots of water, at least 2 liters/day.
5. Chamomile tea may help to soothe nerves and improve mood. Ginger tea may help to relieve bloating.
6. Bananas and green leafy vegetables may help because their magnesium content helps to relax the uterus. Magnesium is also contained in almonds, cashews, peanuts, and black beans.
7. Curcumin (found in turmeric), because of its anti-inflammatory properties is said to help to reduce menstrual cramps.

Lifestyle

1. Regular exercise and physical activity throughout the month help reduce the intensity of dysmenorrhea as opposed to a sedentary lifestyle.
2. Relaxation techniques like deep breathing, mindfulness, and rest during pain can also have beneficial effects.
3. The application of a hot water bag on the abdomen can also provide some relief.

Treatment

1. Pain killers of the non-steroidal anti-inflammatory drug class (NSAIDs) may be prescribed by the doctor.
2. Sometimes drugs that reduce muscle spasms (antispasmodics) may also be prescribed.
3. Oral combined contraceptive pills work by suppressing ovulation, reducing prostaglandin levels, and also decreasing blood flow. This is considered in women who are not looking to conceive.
4. Calcium, vitamin D, fish oil (containing omega 3 unsaturated fats), vitamin E, and vitamin B1, B12 supplements have been used to reduce the intensity of cramps.