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All About Dysmenorrhoea

All About Dysmenorrhoea

by Khor Sulin, Pharmacist

Apart from men, women have to deal with many other 'men' problems like premenstrual syndrome,
menopause, and even dysmenorrhoea. It's an undeniable fact when people say women are noble,
because they really are!

What is dysmenorrhoea?

One of the most common gynaecological complaints, dysmenorrhoea refers to pain or discomfort in
the lower abdomen just before or during menstruation.

Types of dysmenorrhoea & their causes

Depending on the cause, dysmenorrhoea is categorised into two groups – primary and secondary

Primary dysmenorrhoea

Primary dysmenorrhoea is the cramping pain in the lower abdomen occurring just before or during
menstruation in otherwise healthy women. The pain is due to an increased activity of prostaglandin,
a hormone produced in the uterus.

Secondary dysmenorrhoea

Secondary dysmenorrhea refers to menstrual pain related to certain underlying conditions such as:

  • Pelvic inflammatory disease
  • Endometriosis
    • A condition where cells from the uterus lining appear and flourish outside the
      uterine cavity
  • Functional ovarian cysts/fibroids
    • A benign tumour from smooth muscle tissues that originates from the smooth
      muscle layer of the uterus
  • The use of an intrauterine device (IUD) made of copper
    • A type of long-acting reversible contraception
  • Premenstrual syndrome (PMS)
  • Sexually transmitted diseases (STDs)
  • Stress and anxiety

Secondary dysmenorrhoea often develops at a later stage in life, and is more likely to affect women
30 to 45 years old.

Factors associated with severe episodes of dysmenorrhoea:

  • Earlier onset of puberty
  • Long menstrual periods
  • Heavy menstrual flow
  • Smoking
  • Stress
  • Positive family history of dysmenorrhoea

Symptoms of dysmenorrhoea

The pain associated with dysmenorrhoea differs from one individual to another; some may
experience a sharp and throbbing pain while others may feel a dull and aching one.

It is most typically felt in the lower abdomen and may radiate to the lower back, hips or thighs.

Other symptoms include:

  • Nausea or vomiting
  • Diarrhoea
  • Headache
  • Irritability, nervousness or depression
  • Sweating even when it isn't hot
  • Frequent urination
  • Abnormal menstrual bleeding (e.g. heavier or more prolonged menstrual flow)

Treating dysmenorrhoea

Treatment available for primary dysmenorrhoea and secondary dysmenorrhoea consists mainly of
medication and lifestyle changes.


Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are an ideal choice of therapy for
most women. They prevent the production and release of prostaglandins – the hormone responsible
for painful uterine contractions and symptoms like nausea and diarrhoea.

Oral contraceptives are a popular choice for most patients where birth control is also desired. These
contraceptives reduce the volume of menstrual fluid and suppress ovulation.

The treatment for secondary dysmenorrhoea varies depending on the underlying condition, and
includes antibiotics for an infection or a surgery for the removal of fibroids.

Lifestyle changes

Dysmenorrhoea often interferes with the quality of life, but you can easily manage dysmenorrhoea
with these simple lifestyle changes.

  • Avoid cold beverages
  • Eat light but more regular and frequent meals
  • Adopt a diet rich in complex carbohydrates (e.g. whole grains, fruits)
  • Avoid foods and beverages that contain caffeine just before and during your period
  • Take supplements containing vitamin B6, calcium or magnesium to relieve the discomfort
  • Practise relaxation techniques (e.g. meditation, yoga) and exercise regularly
  • If overweight, lose weight by doing regular aerobic exercises
  • Get plenty of rest

Soothe the pain in 3 simple steps

If you wish to reduce the pain of dysmenorrhoea without taking medications, you can try the

  • Apply a hot water bottle on your lower back or abdomen, or soak in a warm tub
  • Gently massage your lower back or abdomen
  • Keep your legs raised while lying down, or lie on your side with your knees bent

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