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What is Dysmenorrhoea? Definition, Types, Cause, Clinical features, Homeopathic Medicine

Definition :
  • Dysmenorrhoea means painful menstruation.
  • painful menstruation,abdominal cramps.
  • Pain arise before or during the flow.it may also be  present after the flow has stop.
Types :

 Primary or spasmodic dysmenorrhoea :
  • Pain due to menstruation and uterine region.
  • Obstructive dysmenorrhoea - a type of spasmodic , a partial or complete obsruction of the genital canal.
  • Membranous dysmenorrhoea - a type of spasmodic, a big pieces of endometriumis casted out.
  • It runs families.
Secondary or congestive dysmenorrhoea:  
  • Pain with menstruation and it felt in lower abdomen and back 3 to 7 before the menstruation and better after menstruation. 
  • The congestion increase beyond the physiological limit it also known as congestive dysmenorrhoea.
Cause :
  • Definite cause is unknown.
  • Associated factors.
primary or spasmodic dysmenorrhoea : 
  • Ischemic condition if uterine muscles.
  • Conical cervix, uterine malformation like rudimentory horn or septate uterus.
  • Physiological factor.
  • Low pain threshold.
  • Constitutional factor.
  • Neurogenic cause.
  • Impair state of health.
  • Hypoplasia factor.
  • Retroverted uterus.
  • Narrow hymen.
Secondary or congestive dysmenorrhoea :
  • Uterine fibroid.
  • Pelvic endometriosis.
  • Chronic pelvic inflammation.
Clinical feature : 

 primary or spasmodic symptoms : 

  • Commonly young age 18 to 25 year.
  • Menstrual pain may occur from Menarche and continue 2 to 4 years. 
  • Menstrual pain begins 1- 2 hour before onset of menses and continues from 12 to 24 years and then gradually reduce.
  • Clocky, cramp like pain.
  • No pain during inter menstrual period.
  • Nausea and vomiting associated with pain. 
Primary or spasmodic sign : 

  • Usually poor and anxious mind.
  • Per abdominal examination nothing is abnormal.
  • Per vaginal examination uterus is normal.
  • Prognosis usually cured by pregnancy and childbirth after marriage.
Secondary or congestive symptoms :

  • Commonly elder age above 30 years.
  • Menstrual pain occurs after painless menstruation.
  • Menstrual pain begins 3-5 days before onset of menses after which the pain gets less.
  • Dull aching pain in the back.
  • During inter menstrual period may have backache.
  • Menorrhagia, white discharge, infertility are associated symptoms with pain.
Secondary or congestive sign :

  • Usually healthy person.
  • Per abdomen primary lesion may be present.
  • Per vaginal examination pathology present.
  • Prognosis  no such characteristic.
Investigation :

  • History of menstrual, cycle, blood loss, pain.
  • Past history.
  • Obstretical history.
  • Family history.
  • Blood Hb test for anaemia.
  • Pelvic examination.
  • Chlamydial and gonococcal culture.
  • Complete and differential blood count.
  • DNA prob test.
  • Urinalysis
  • stool test.
  • Quantitative human gonadotropin level.
  • Enzyme immunoassay.
If pelvic pathology is present, the following studies may be considered:
  • Computed tomography
  • Magnetic resonance imaging
  • Abdominal or transvaginal ultrasonography
  • Hysterosalpingography
  • Intravenous pyelography
Other more studies may be considered are as follows:
  • Dilatation and curettage
  • Laparoscopy
  • Hysteroscopy
Management :

 Primary or spasmodic type and secondary or congestive type :
  • Preventive - proper sex education start from menarche.
  • Curative - symptomatic treatment of causes.
  • Proper rest. 
  • Encouraged to pursue daily activities.
  • Bowel should be regularised.
  • Personal hygiene.
  • Good diet.
  • Open air exercise.
Operative :
  • Cases where dysmenorrhea is of uterine origin and medical treatment fails.
  • D and C advisable.
  • Provided she is not teenaged.
Homoeopathic medicine :

 Belladonna :
  • Congestive dysmenorrhea.
  • The pain stop the fiow, to head and confusion of sight,
  • Bearing down sensation as if everything is through out from vulva.
  • Pain come suddenly and go suddenly.
  • Copious discharge with a bright red colour blood.

 Pulsatilla :
  • Delayed menses.
  • Thick and black blood.
  • Flowing by fits and starts with chilliness.
  • Feeling of heaviness like a stone in pelvic cavity.
  • Pain is so violent tosses in all direction with cries and tears.
  • Numbness and drawing sensation extending down the thighs.
  • Aggravate in warm room.
Cimicifuga :
  • Profuse or scanty flow of coagulated blood.
  • Severe pain in back, through the hip and down thighs.
  • Labor like pain with pressing down.
  • Neuralgic type of pain.
  • Historical spasm, tenderness and cramps of hypogastric region.
Sepia ;
  • Menses too early and scanty.
  • Great bearing down sensation.
  • Bearing down sensation better by cross her limbs.
  • Colicky pain in abdomen.
  • Leucorrhoea before menses.
  • Leucorrhoea excoriating the parts.
Biochemic medicine :

 Magnasia phose :
  • This is the chief remedy for the excessive crampy pain in abdomen in dysmenorrhea.
  • Membraneous dysmenorrhea.
  • Pain just before the flow begins.
  • A small quantity of the remedies should be dissolved in hot water and applied with clothes immediately over the uterus.

 Ferrum phose :
  • Membraneous dysmenorrhea.
  • Excessive congestion during period.
  • Painful menstruation.
  • Bright red blood.
  • Flush the face and quick pulse.
  • Vomiting with undigested food.
Calcarea phose :
  • During puberty the patient has not been careful with consequent dysmenorrhea.
  • Labour like pain before and during catamenia.
  • Pain with violent backache, Vertigo, sexual excitement and throbbing headache.
Natrum mur :
  • Menses scanty and dark with frontal headache.
  • Fever blisters on lips.
  • During summer to urticarious eruption.
  • Sour burning in vagina.
  • Cutting burning in the womb.
  • Menses too early and to profuse with brusting headache and frequent shivering.
Other non medicinal treatment for dysmenorrhoea :
  • lying on your back, supporting your knees with a pillow.
  • Take warm bath.
  • Massage your abdomen.
  • mild exercises like walking, biking and stretching.
  • exercises improve blood flow and reduce pain.
  • yoga.
  • Heating pad or hot water bottle holding on your back and abdomen. 

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