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.