Menstrual cramps are also called as dysmenorrhea in medical practice and it is described as painful lower abdominal cramps occur immediately before or during menstruation. A huge number of females of all reproductive ages suffer from menstrual cramps that interfere with their day to day life. Therefore, first aid training regarding menstrual cramps would be really helpful to eliminate the suffering of these women during their menstrual periods.
There are two basic types of dysmenorrhea:
- Primary dysmenorrhea
- Secondary dysmenorrhea
Primary dysmenorrhea is the commonest type menstrual cramps. This starts within first two years after attending the puberty. These episodes can be ranged from mild, moderate to severe forms. The abdominal pain begins with menstrual bleeding and last only during menstrual period. Usually there is no identifiable underlying pathology in female reproductive organs (uterus, ovaries, fallopian tubes, uterine cervix and the vagina) of these patients.
Secondary dysmenorrhea starts several years after the menarche (first menstrual period) and it occurs due to some underlying disorder of the reproductive tract. Pain begins few days prior to periods and lasts throughout the periods or even few days after their end.
Common causes for menstrual cramps-
A. Primary dysmenorrhea– occurs usually due to painful uterine contractions. Excessive prostaglandin levels found in uterus causes these violent, hence painful contractions.
B. Secondary dysmenorrhea –
• Adenomyosis- endometrial tissue (tissue that lines the innermost layer in the wall of the uterus) implants within the muscular wall of the uterus and causes severe pain during menstruation due to cyclical bleeding into the muscle rather than into the uterine cavity under normal conditions.
• Fibroids- benign tumors occur within uterine wall and cavity.
• Endometriosis- endometrial tissue implants on pelvic organs, abdominal cavity and elsewhere in body.
• Sexually transmitted diseases.
• Pelvic inflammatory disease – due to infection spreading into the pelvic cavity from reproductive organs.
• Intra uterine contraceptive device (IUCD) –Specially causes dysmenorrhea during first few months after implantation.
• Ovarian tumors.
Symptoms of painful menstrual cramps
• Dull, cramping, throbbing pain in lower abdominal region.
• Pain radiating to back.
• Nausea, vomiting.
• Sweating.
• Dizziness.
• Loose stools.
• Headache.
• Fainting
• Severe pain within first 24 hours of onset of menstruation.
First aid management and home remedies
1. Have adequate rest during first day of periods.
2. Try adopting different postures that eases the pain most. For an example; lying on side while bending knees towards chest wall, or lying on the back and keeping legs elevated by a pillow. These maneuvers will help to ease your abdominal wall muscles and reduce the pain.
3. Apply heat, like hot water bottle, hot water pad on to the lower abdominal wall and massage gently over the back and lower abdomen. Or take a hot water bath. Be careful not to keep warm things on skin for too long at a time or it may cause burns.
4. Drink warm beverages.
5. Exercise, especially prior to menstruation will relieve the pain in some women. This will increase the blood flow to uterus washing the prostaglandins away reliving the pain.
6. Over the counter non-steroidal anti-inflammatory drugs (NSAIDs) – inhibits the formation of prostaglandins in body/uterus. Prostaglandin is the hormone responsible for primary dysmenorrhea. Therefore, NSAIDs are effective in reduction of menstrual pain in patients with primary dysmenorrhea. (E.g. – mefenamic acid, ibuprofen). NSAIDs reduce the menstrual blood loss in addition to pain relief.
7. Take healthy diet with more fresh fruits, vegetables and water. Fiber content of the above foods will clear the excess estrogen. Which will eventually leads to reduction in menstrual cramps.
8. Avoid foods containing caffeine and too much salt and avoid smoking and alcohol as well. Those will worsen the cramps.
9. Keep bladder empty as much as possible.
10. Vitamin E, thiamine and omega- 3 supplements may help in some cases.
11. Practice relaxation techniques like breathing exercises, yoga.
12. Control the body weight if you are overweight.
13. Do not wear too tight clothes.
14. Oral combined hormonal contraceptive pills can be used as the last option of menstrual cramp controlling. Contraceptive pills prevent ovulation and reduce severity of menstrual cramps. Seek medical advice before taking these for the first time.
15. Contact your doctor if associated with fever, sudden severe pain, pain not relived with medications, pain and intra uterine contraceptive device at the same time and there is excessive menstrual bleeding with passage of blood clots.
Online References:
http://www.home-remedies-for-you.com/remedy/Menstrual-Cramps.html
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Menstruation_dysmenorrhoea
http://www.emedicinehealth.com/menstrual_pain/page6_em.htm#menstrual_cramps_remedies_and_relief
http://women.webmd.com/menstrual-cramps
http://www.mayoclinic.com/health/menstrual-cramps/DS00506