– Painful Menses / Dysmenorrhoea
Painful periods are common in teenagers and young adults.
Primary dysmenorrhoea is the most common type of painful periods. This is where there is no underlying problem of the womb (uterus) or pelvis. It often occurs in teenagers and women in their 20s.
Secondary dysmenorrhoea is pain caused by a problem of the womb or pelvis. This is less common, and is more likely to occur in women in their 30s and 40s.
The main symptom is crampy pain in your lower abdomen.
May spread to your lower back, or to the top of your legs.
Usually starts as the bleeding starts, but it may start up to a day before.
Usually lasts 12-24 hours, but lasts 2-3 days in some cases.
Can vary with each period. Some periods are worse than others.
Tends to become less severe as you get older, or after having a baby.
The following may indicate secondary dysmenorrhoea:
If you have a change in your usual pattern of pain. For example, if your periods become more painful than they used to be, or the pain lasts longer than it used to. In some women with secondary dysmenorrhoea the pain starts several days before the period begins, and lasts all the way through the period
Other symptoms may include.
Bleeding between periods.
Pains between periods.
The bleeding becomes heavier than previously.
Pain during sex.
It is important to differentiate between the primary and secondary dysmenorrhoea; the treatment depends on the underlying cause. Supportive care and Anti-Inflammatory medication help control the severity of symptoms.
– Excessive Bleeding/ Menorrhagia
Menorrhagia is defined as menstruation at regular cycle intervals but with excessive flow and duration. Clinically, menorrhagia is defined as total blood loss exceeding 80 mL per cycle or menses lasting longer than 7 days.
Young patients, from menarche to the late-teen years, most commonly have anovulatory bleeding due to the immaturity of their hypothalamic-pituitary axis.
Women aged 25-50 years may have organic or structural abnormalities. Uterine Fibroidsor polyps are frequent findings.
Postmenopausal women with any uterine bleeding should receive an immediate workup for endometrial cancer.
Pregnancy should be excluded before further testing or medications are advised.
Other differential diagnoses must be kept in mind while assessing a patient with menorrhagia
Investigations : Pelvic ultrasound is the best noninvasive imaging study to assess uterine shape, size, and contour; endometrial thickness; and adnexal areas.
Successful treatment of chronic menorrhagia is highly dependent on a thorough understanding of the exact etiology. Treatment must be individualized based on the cause of bleeding.Leave a reply →