Painful Menses- accept or not!!

This Woman’s month let’s demystify one myth for Women’s Health.

For years women have been told to accept Dysmenorrhea or menstrual pain as a part of being women. It’s nothing but a MYTH.

To all ladies out there, if your periods/menses are painful to the extent that constantly it reminds you that u have a different day today or u aren’t able to perform your daily routine with the same zeal. And same applies to all the men. If you see females in your family or circle suffering, do not let it happen and make them aware for they need to attend it.

Please take action! Get yourself checked. There are various ways how you can get rid of it, get right investigation and treatment done.

As imagine a lady not able to work for 2-5 days every month. We are losing so much of productive life force to this simple treatable health condition. In a total of 24 days minimum a year if I consider even 2 days of non-health period. Woman loses 1 month of productive, happy life only because of menstrual pain.

And if you are looking for pain relief from a severe form of dysmenorrhea or a nagging menstrual discomfort, choose homeopathy. A rightly chosen homeopathic remedy can completely remove the menstrual pain and its cause and let you live your dreams for those 5 days like rest of the month and won’t hold you back.

Let’s understand the issue a little bit.

Dysmenorrhoea, or painful menstruation, is one of the most frequent gynecological complaints but also a most ignored one. Severe dysmenorrhoea is most prevalent in young women leading sedentary lives, and its frequency has some economic importance, for the patients are often incapacitated from work for one or more days during each period. Although dysmenorrhoea should not be regarded as a serious affection, its treatment is of great importance to the practicing physician in view of the interruption in the patient’s economic and social life, not to mention the important psychological effects.¹

The usual method of classifying the different types of dysmenorrhea is to identify three groups¹

• Congestive
• Spasmodic
• Membranous

CONGESTIVE DYSMENORRHOEA

Starts before the menses is the keynote indicator.

This takes the form of premenstrual pain situated either in the back or lower abdomen, occurring between three and five days and sometimes even longer before the onset of menstruation; it is always relieved by the menstrual flow. Inflammatory disease such as salpingooophoritis parametritis and pelvic adhesions almost always produce the symptoms of congestive dysmenorrhoea, probably because the ovaries are hyperaemic and covered by adhesions from the inflammatory lesions so that they become tense during the premenstrual phase of the menstrual cycle. Congestive dysmenorrhoea is a common symptom of certain myomas, of chocolate cysts of the ovaries of adenomyomas and acquired retroversion of the uterus. Not all patients, however, who suffer from congestive dysmenorrhoea have an organic basis to account for their pain. In others, the pain or discomfort is referred to one or other iliac fossa, usually the left, and it is accompanied by an alteration in bowel habit, usually constipation, with some flatulent distension of the upper colon. The basis here is a colon spasm and the descending colon can be palpated as a tender, obviously spastic segment.¹

Cause & treatment

The real cause of the condition is a sympathetic imbalance, influenced by the cyclical changes in the adjacent genital tract. The correct treatment is appropriate diet and the avoidance of excess carbohydrate and strong purgatives, and some antispasmodic drug to help acutely. This shall be accompanied by deep acting totality based remedies in homeopathy which will treat the cause and thus remove the tendency to dysmenorrhea. Another important factor is Exercise since they are usually sedentary office workers.¹

SPASMODIC DYSMENORRHOEA

The majority of cases of dysmenorrhoea fall into this group, and it is probable that nearly 50% of the adult female population suffer at sometime from varying degrees of this symptom, though less than 10% will seek medical advice. The patient’s history is very characteristic. The pain develops on the first dayof the menstrual period, when excruciating lower abdominal pain is experienced which lasts for a relatively short time, perhaps for half an hour toan hour. This severe pain is intermittent and spasmodic, and maycause collapse, vomiting or nausea. The severe attack of pain isfollowed by a similar but less pronounced type of pain, felt in the lower abdomen and pubis, and often down the antero-medial area of thethighs. Such pain persists usually for not more than 12 hours.¹

It is important to realize that there is much variation in the type of pain experienced by patients with spasmodic dysmenorrhoea. Sometimes considerable discomfort starts on the day before the menstrual flow and may persist after the actual severe pain has lessened for more than 12-24 hours. Similarly, premenstrual pain may be complained of, either in the back or lower abdomen, which leads up to the excruciating pain felt on the first day period. The severity of the pain varies greatly. Sometimes it is extremely severe, causing vomiting well- marked shock incapacitating the woman from her employment.¹

In Spasmodic dysmenorrhoea, the condition does not become established until two or three years after the menarche when ovulatory cycles are established though there may be a degree of discomfort associated with earlier periods. Suppression of ovulation by oestrogens can be used to produce a painless period. It is rare to encounter severe spasmodic dysmenorrhoea in women over the age of 35, and it is exceptional for the excruciating pain to persist after that age, although the less severe pain lasting during the first day of the period is usually seen until the woman approaches menopausal age.¹

Spasmodic dysmenorrhoea is usually cured by pregnancy, and exceptions to this rule are infrequent.¹

Some degree of menstrual irregularity is not uncommon with spasmodic dysmenorrhoea. Sometimes the onset of puberty is delayed, and the menstrual cycle is a little irregular. In spasmodic dysmenorrhoea the amount lost during each period is less than the average, and not infrequently patients give a history that the severe pain is relieved by the passage of a clot.¹

Aetiology

1. Muscular spasm: The pain is due to muscular spasm which is sufficiently intense to cause ischaemia.¹ Progesteronestimulates myometrial contraction of the smooth muscle of the cervix and causes narrowing of the cervical canal. Progesterone further stimulates the production of prostaglandin F₂ alpha which in turn accentuates pain.¹
2. Dysmenorrhoea is invariably associated with ovulatory cycles. Women on oral contraceptive pills are rendered anovulatory and relieved from dysmenorrhoea.¹
3. Psychogenic causes: Women having a low threshold for pain, and those predisposed to undue fears and anxiety are most susceptible to this disorder.¹
4. Nerve pathways: It has been suggested that muscle spasm of the uterus maybe a result of an imbalance of the autonomicnerve supply of the uterus. Surgical division of the pre-sacral nerve at Cotte’s operation interrupts the sensory pathway of pain and alleviates pain during menstruation.¹
5. Intrauterine contraceptive device may induce dysmenorrhoea due to uterine cramps by the foreign body, or by the increased secretion of prostaglandin. If the endometrium secrets excess of PGF₂ alpha, uterine contractions initiated by this prostaglandin can produce spasmodic dysmenorrhoea.¹

Investigations

This depends upon the severity of the symptoms, incapacitation and of pelvic pathology. Therapeutic trial with drugs may be worthwhile before resorting to invasive investigatory procedures, especially in a young unmarried girl. Ultrasound may reveal mild organic pelvic lesion but may not reveal endometriosis. Hysterosalpingography, laparoscopy and hysteroscopic investigations are resorted to only when the therapeutic trial fails.¹

Treatment¹

1. Explanation of menstrual process, sex education and reassurance to the patient are important aspects of management.
2. Nourishing diet, correction of constipation, physical exercise and inculcating regular habits are necessary.
3. Homeopathic remedies can be used for pain relief during acute attack in initial phase and this has to be supported by deep acting remedies which will remove the tendency to dysmennorrhoea and treat the basic cause of pain thus producing long lasting effects.

MEMBRANOUS DYSMENORRHOEA

This is an extreme form of spasmodic dysmenorrhoea. It is extremely rare, run in families and to recur after pregnancy. It is accompanied by the passage of membranes which may take the form of casts of the uterine cavity. Microscopically the casts have the structure of the endometrium during menstruation, except that the disintegrative processes are ill- defined.¹

ROLE OF HOMEOPATHY IN DYSMENNORHOEA

Homeopathy has a very good well-defined role in treating Dysmenorrhea. Arightly chosen remedy based on totality-based treatment.  It might take few weeks to few months which depending on how long the patient had the condition and how severe was the condition. Medicines shall be taken in consultation with a homeopathic physician only.

At our clinic we use a totality-based approach and entire history is taken to find the correct homeopathic remedy so the female can be helped rightly and get rid of this nagging problem. The remedy not just helps relive dysmenorrhea but overall improves the female health status.

References

1. Howkins &Bourne SHAW’S TEXTBOOK OF GYNAECOLOGY. 12^thed. New Delhi: B.I. Churchill Livingstone; 1999. 407p.
2. Boericke W. New Manual of Homœopathic Materia Medica and Repertory. 9th Reprinted Edition. New Delhi: B Jain Publishers (P) Ltd; 2005.
3. Lilienthal, S. Homoeopathic therapeutics. Philadelphia: Boericke& Tafel; 1907
4. Dewey WA.Practical homeopathic therapeutics.3rd ed.New Delhi:  B. Jain Publishers(P) LTD.;2009.