WHAT IS DYSMENORRHEA? HOW IS IT TREATED?
DYSMENORRHEA IS A CONDITION IN WHICH PAIN IS FELT DURING MENSTRUATION, WHICH CAN START WITH THE FIRST MENSTRUATION IN YOUNG GIRLS.
THE PAIN MAY BE ACCOMPANIED BY NAUSEA, VOMITING AND CRAMPS IN THE LOWER ABDOMEN.
SOMETIMES THE CRAMPS CAN RADIATE DIRECTLY TO THE LEGS. IN THE PATHOLOGIC TYPE, THE PAIN MAY CONTINUE AFTER MENSTRUATION.
DYSMENORRHEA IS DIVIDED INTO TWO TYPES.
**PRIMARY DYSMENORRHEA:
THIS IS THE MOST INNOCENT TYPE. IT CAN DISAPPEAR WITH ADVANCING AGE AND AFTER CHILDBIRTH. IT OCCURS MOSTLY IN YOUNG GIRLS AFTER THE FIRST MENSTRUATION. DURING MENSTRUATION, THE UTERUS CONTRACTS WHILE EXPELLING MENSTRUAL BLOOD AND DURING THIS TIME, WITH THE NATURAL PRODUCTION OF SOME CHEMICALS, THERE MAY BE CRAMP-LIKE PAIN UNDER THE NAVEL, NAUSEA AND EVEN VOMITING.
THERE IS NO PATHOLOGY IN THE UTERUS, OVARIES AND INTERNAL GENITAL ORGANS. THE PAIN USUALLY STARTS WITH MENSTRUAL BLEEDING AND DISAPPEARS ON THE SECOND OR THIRD DAY.
**SECONDARY DYSMENORRHEA:
IN THIS TYPE, PAIN INCREASES WITH MENSTRUAL BLEEDING BUT MAY CONTINUE AFTER MENSTRUATION. SOMETIMES PAIN MAY START BEFORE MENSTRUATION STARTS. IT IS MORE COMMON IN OLDER AGES. ALSO, PAIN AND CRAMPS MAY LAST LONGER IN THIS TYPE. IN SECONDARY DYSMENORRHEA, THERE IS A CONCOMITANT PATHOLOGICAL CONDITION IN THE INTERNAL GENITAL ORGANS. IT IS IMPORTANT TO DETERMINE THIS AND TO ORGANIZE TREATMENT ACCORDINGLY. THE MOST COMMON CONCOMITANT DISEASES ARE:
1-MYOMS
2-CHOCOLATE CYSTS (ENDOMETRIOSIS)
3- ADHESIONS DUE TO PREVIOUS FEMALE GENITAL TRACT INFECTION
4-CONGENITAL ANOMALIES OF UTERINE STRUCTURE
5-INTRAMURAL DRIVING
6-TISSUE ADHESIONS DUE TO PREVIOUS GYNECOLOGICAL INTERVENTIONS
7-ENDOMETRIAL OR CERVICAL POLYPS
DIAGNOSIS:
GYNECOLOGIC EXAMINATION FINDINGS AND MEDICAL HISTORY OF THE PATIENT ARE VERY IMPORTANT IN DIAGNOSIS. THE ONSET AND COURSE OF THE PAIN SHOULD BE CONSIDERED IN RELATION TO MENSTRUATION. IN CASES WHERE GYNECOLOGIC EXAMINATION AND ULTRASOUND ARE NOT SUFFICIENT, LAPAROSCOPIC (EXAMINATION OF INTERNAL ORGANS WITH A CAMERA) EXAMINATION CAN BE PERFORMED AS AN AUXILIARY.
TREATMENT:
THE MEDICATIONS OF FIRST CHOICE ARE PAINKILLERS, BIRTH CONTROL PILLS CAN BE USED IN PATIENTS WITH INSUFFICIENT CONTRACEPTIVES, MAGNESIUM MASSAGE, HEAT APPLICATION, HERBAL MEDICINES, EXERCISE, MEDIATION AND YOGA CAN BE RECOMMENDED AS AN ADJUNCT. THESE CAN PROVIDE AN EFFECTIVE SOLUTION TO PRIMARY DYSMENORRHEA. IN SECONDARY DYSMENORRHEA, SURGICAL TREATMENT MAY BE REQUIRED FOR THE CAUSE.
