Experiencing painful periods is a significant issue, impacting women's performance at school and work. In extreme cases, about 10% of women may need bed rest due to severe symptoms. Painful periods, known as dysmenorrhoea, can be categorized into two types:
Primary Dysmenorrhoea:
- Begins about a year after the onset of periods, most common between ages 15 and 25.
- Symptoms include cramping pain in the lower abdomen, potentially moving to thighs and lower back.
- Usually noticed about a day before the period starts, with symptoms typically decreasing with age.
- Treatment includes anti-inflammatory medication, combined oral contraceptives, paracetamol, alverine citrate, and other non-drug options like TENS devices.
Secondary Dysmenorrhoea:
- Uncommon before the age of 25.
- May involve heavy bleeding, painful intercourse, or infertility.
- Causes include endometriosis, pelvic inflammatory disease, fibroids, womb polyps, pelvic congestion syndrome, intra-uterine contraceptive device, and ovarian cysts.
Endometriosis:
- Affects about 10% of reproductive-age women.
- Symptoms can be non-specific, often mimicking other conditions.
- Causes pelvic pain, menstrual cramps, fatigue, and depression.
- Associated with infertility, heart disease, arthritis, and more.
- Diagnosis involves considering symptoms, a pelvic examination, and an ultrasound scan.
- Medical management includes pain relief, hormonal therapies, and sometimes surgery for severe cases.
- Endometriosis may impact fertility and tends to resolve during menopause.
Adenomyosis:
- Presence of womb lining tissue in the muscle layer of the womb.
- Commonly diagnosed in women aged 40 to 50.
- Symptoms include painful, heavy, or abnormal periods and an enlarged womb.
- Treatments involve hormonal contraceptives, high-dose progesterone-based medications, and the intra-uterine system (e.g., Mirena coil).