More than 85 percent of women in reproductive age experience painful menstruation. Sometimes, there may not be any associated medical condition to the monthly pain. In this case, we call it primary dysmenorrhea.
However, in other case, conditions that can cause painful menstruation include: endometriosis, Pelvic Inflammatory Disease (PID), adenomyosis, cervical stenosis, fibroid, intrauterine adhesion, Intra uterine contraceptive devices. Once there is identifiable cause, we call painful menstruation- secondary dysmenorrhea.
Patient with secondary dysmenorrhea respond minimally to even pain relieving drugs.
It is important to note that there is always an underlying cause of secondary dymmenorhea. This should be suspected in a woman who for about 1-2 years of painless menstrual flow is now having menstrual pain, if there is irregular or heavy flow with the pain, poor response to medication, vagina discharge or infertility.
WHAT WILL MY DOCTOR DO?
If your doctor is thinking in line of secondary dysmennorhea, he/she might need to do pelvic examination for you which include:
Inspection of external genitalia (outside part of your reproductive system) for rashes, swelling and discoloration
Inspection of the vagina for discharge or blood.
Inspection of the cervix
Bimanual examination to know if there is uterine mass or adnexal tenderness
After the examination, your doctor will request for the following investigations:
High vagina swab and endocervical swab to exclude pelvic infection in particular Chlamydia trachomatis and Neisseria gonorrhea.
Abdominopelvic scan
Transvaginal ultrasound scan
Diagnostic laparoscopy
TREATMENT OPTIONS
- Lifestyle modification: This include exercising, consumption of vegetables, low fat diet and cessation of smoking.
- Used of NSAIDs e.g Ibuprofen, Mefenamic acid, diclofenac etc.
- Use of Levonorgestrel I.U.D.
- Use of antibiotics where indicated
- Surgical intervention might be needed in some cases of secondary dysmenorrhea.
Dr. Adeyemo Olusola is a medical graduate of Olabisi Onabanjo University, Ogun State, Nigeria along with certificate in advanced diploma in Principles of Nutrition, Management and Leadership, Dublin and Certificate in Global Health from London School of Hygiene and Tropical Medicine. In addition to his numerous certifications, he is a certified Telemedicine Physician from Harvard Medical School, USA. He is an avid reader of books from different oases of life, expert in Medical Statistics and an award winner at both local and international level. “So many a time, I have seen people die avoidable death because of lack of knowledge or information, falling victim of fate. There is then a necessity laid on us to help arm our society to the teeth, as a healthy society cannot be detached from an informed one. Hence, there is need for healthgist.net. We hope you will have a wonderful stay on our website.”
