The cramping sensation is intensified when clots or pieces of bloody tissue from the lining of the uterus pass through the cervix, especially if a woman s cervical canal is narrow. Secondary dysmenorrhea may be evident at menarche, but more often, the condition develops later. Today, when a woman has abnormally heavy and painful uterine bleeding, her doctor may recommend endometrial ablation, a procedure in which the lining of the uterus is destroyed by various devices. How are menstrual cramps diagnosed? The diagnosis of menstrual cramps is usually made by the woman herself and reflects her individual perception of pain. Menstrual cramps usually begin before the onset of menstrual period, peak within 24 hours after the onset of the bleeding, and subside again after a day or two. When a woman with dysmonorrhea has menstrual cramps, her contractions are usually of a higher pressure (they may exceed 400 mm Hg), last longer than 90 seconds, and often occur less than 15 seconds apart. There are a number of underlying conditions which can contribute to the pain including: Endometriosis (cells from the uterine lining tare located in other areas of the body outside of the uterus) Adenomyosis (a benign condition in which the cells of the inner uterine lining invade its muscular wall, the myometrium). The NSAIDs that do not require a prescription are: ketoprofen (Actron, Orudis KT) two femmes dating. Prescription NSAIDs available for the treatment of menstrual cramps include mefenamic acid (Ponstel) and meclofenamate (Meclomen). Some women find that abdominal massage, yoga, or orgasmic sexual activity may bring relief. Can menstrual cramps be measured? Yes, but measuring the strength of menstrual cramps is not routinely done in clinical practice. Are there surgical solutions? In the past, many women with menstrual cramps had an operation known as a D & C (dilation and curettage) to remove some of the lining of the uterus. Why are some cramps so painful? Menstrual cramps are caused by the uterine contractions that occur in response to prostaglandins and other chemicals. The woman s estrogen and progesterone hormone levels decline, and the lining of the uterus becomes swollen and is eventually shed as the menstrual flow. Pain also may be felt in the inner thighs, or hips. Therefore, an adolescent girl may not experience dysmenorrhea until months to years following the onset of menstruation. Physical exercise can help alleviate menstrual cramps. Quick GuidePremenstrual Syndrome (PMS): Track and Prevent Symptoms What if the cramps are very severe? If a woman s menstrual cramps are too severe to be managed by these strategies, her doctor might prescribe low doses of birth control pills (oral contraceptives) containing estrogen and progestin in a regular or extended cycle. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat cramps. A number of nonprescription (over-the-counter) agents can help control the pain as well as actually prevent the menstrual cramps altogether.

Use of an IUD that releases small amounts of the progestin levonorgestrel directly into the uterine cavity, has been associated with a 50 percent reduction in the prevalence of menstrual cramps. Severe menstrual cramps can be so painful that they interfere with a woman s normal activities for several days. Some women experience an urge to urinate more frequently. For mild cramps, aspirin or acetaminophen (Tylenol), or acetaminophen plus a diuretic (Diurex MPR, FEM-1, Midol, Pamprin, Premsyn, and others) may be sufficient. These compounds cause the muscles of the uterus to contract. Women with menstrual cramps have elevated levels of prostaglandins in the endometrium (uterine lining) when compared with women who do not experience cramps. In secondary dysmenorrhea, some underlying abnormal condition (usually involving a woman s reproductive system) contributes to the menstrual pain. Menstrual bleeding usually begins before the onset of ovulation. What is the treatment of secondary dysmenorrhea? The treatment of secondary dysmenorrhea depends on its cause. The main agents for treating moderate menstrual cramps are the nonsteroidal antiinflammatory drugs (NSAIDs), which lower the production of prostaglandin and lessen its effect. The difference between menstrual cramps that are more painful and those that are less painful may be related to a woman s prostaglandin levels. After ovulation, if the egg is not fertilized by a sperm, no pregnancy will result and the current lining of the uterus is no longer needed two femmes dating. Other substances known as leukotrienes, which are chemicals that play a role in the inflammatory response, are also elevated at this time and may be related to the development of menstrual cramps. However, aspirin has limited effect in curbing the production of prostaglandin, and it is only useful for less painful cramps. Medically, menstrual cramps are called dysmenorrhea. This type of approach can prevent ovulation (the monthly release of an egg) and reduce the production of prostaglandins which, in turn, reduces the severity of cramping. During a normal menstrual period, the average woman has contractions of a low pressure (50-80 mm Hg), which last 15-30 seconds at a frequency of 1-4 contractions every 10 minutes. Menstrual cramps tend to improve with age. This contraction blocks the delivery of oxygen to the tissue of the endometrium which, in turn, breaks down and dies. What are menstrual cramps? Menstrual cramps are pains in the abdomen and pelvic areas that can be experienced by a woman as a result of her menstrual period.

The discomfort can extend to the lower back or legs. A woman should start taking one of these medications before her pain becomes difficult to control. Researchers have demonstrated that menstrual cramps can be scientifically documented by measuring the pressure within the uterus, as well as the number and frequency of uterine contractions. Menstrual cramps can range from mild to quite severe. More than half of all menstruating women have cramps. There are a number of possible remedies for menstrual cramps. This might mean starting medication 1 to 2 days before her anticipated period is due, and then continuing taking the medication for the first one to two days of her period. What causes menstrual cramps? Each month, the inner lining of the uterus (the endometrium) normally builds up in preparation for a possible pregnancy. Many women suffer from both PMS and menstrual cramps. When the uterine muscles contract, they constrict the blood supply (vasoconstriction) to the endometrium. Secondary dysmenorrhea results from an underlying abnormality that usually involves the woman s reproductive system. A heating pad applied to the abdominal area may relieve the pain and congestion. The cramps are severe in at least one in seven of these women. In contrast, IUDs that do not contain hormones, such as those containing copper, may worsen menstrual cramps. What other factors influence menstrual cramps? Menstrual cramps are pains that begin in the lower abdomen and pelvis. Menstrual cramps can also be accompanied by either constipation or diarrhea, because the prostaglandins which cause smooth muscles to contract also affect the intestinal tract. Menstrual cramps are not the same as the discomfort felt duringpremenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced as a continuous process. The best results are obtained by taking one of the NSAIDs on a scheduled basis and not waiting for the pain to begin. Mild menstrual cramps may be barely noticeable and of short duration. .

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