What is dysmenorrhea?

Painful periods  ,” recalls Dr. Jean-Michel Morel, “are also called dysmenorrhea, which indicates a dysfunction of menstruation. To be even more precise, we could talk about oligomenorrhea, which adds the notion of algia, of pain.

We can differentiate two types of dysmenorrhea:

Primary dysmenorrhea: which appears in young girls from the first menstruation and which most of the time tends to improve over the years, after the first sexual intercourse or pregnancy. Risk factors are heredity, early or heavy periods, hormonal disturbances, excessive secretion of prostaglandins, anxiety or chronic stress, etc.

Secondary dysmenorrhea: which appears during genital life. The causes are often organic – the presence of a fibroid, a polyp, endometriosis, etc. This dysmenorrhea can also be caused or aggravated by a copper IUD.

In both cases, period pain, like any type of pain, should not be considered normal, even if it is benign. It is advisable to consult a doctor to find therapeutic solutions and in some cases to carry out the necessary investigations to understand the causes.

What are the symptoms of dysmenorrhea?

Period pain occurs in different ways:

Intense cramping or spasm-like pain in the lower abdomen, sometimes extending throughout the abdomen, lower back, thighs, etc. Some women compare painful periods to a hand crushing the uterus.

A multitude of unpleasant sensations: nausea and even vomiting, paleness, dizziness, significant fatigue, headaches, diarrhea, mood swings, etc. Some women say they do not recognize themselves during this period.

This procession of symptoms has the particularity of setting in quite suddenly, as soon as the period arrives. It persists from a few hours to a few days and disappears relatively quickly.

What’s going on in my stomach?

Dr. Jean-Michel Morel explains: “During the second part of the cycle, after ovulation, the ovary secretes two types of hormones, progesterone and estrogen. In the presence of the latter, the uterine wall thickens and becomes vascularized in the event of receiving an egg. If there is no fertilization, the sudden drop in hormones at the end of the cycle causes the uterus to be evacuated in the form of bleeding. This is called menstruation. Uterine contractions caused by chemical mediators, prostaglandins, allow this process. The more the blood vessels compress, the more the muscles are deprived of oxygen and the more the pain increases. This excess of prostaglandins also plays a role in the appearance of associated signs of discomfort: migraines, nausea, etc. In addition, it is also assumed that dysmenorrhea and premenstrual syndrome are closely linked. Indeed, when in the second part of the cycle progesterone is not or insufficiently secreted, the premenstrual syndrome is more marked and subsequently, the periods tend to be more painful. Any imbalance, fluctuation, or lack of coordination between the secretions of estrogen and progesterone causes disturbances in the cycle and promotes the phenomenon of dysmenorrhea. The variations in physiological reactions explain the differences in sensations from one month to the next, and also from one woman to another. Without forgetting that a poor lifestyle, stress, tobacco, alcohol, etc. can also accentuate the painful sensations.

What are the consequences of painful periods?

Painful periods are not without consequences for women; they can lead to:

• A disruption to daily life: difficulty working, playing sports, concentrating, simply staying on your feet for a long time…
• Absenteeism from school or work: Because of the pain, some women have to take days off during their periods
• A recovery time necessary to regain energy: restoration of nighttime sleep, nap or break time, gradual resumption of physical activity
• In case of painful and heavy periods: constant stress of being in a difficult situation to manage, such as stained pants or bedding
• Anticipatory anxiety sets in before your period; the unpleasant feeling of not having control over this recurring pain.

When to worry about period pain?

You should consult as soon as possible:

• When heavy periods require changing protection more than 6 times a day
• In case of extreme fatigue, malaise, unusual feeling of thirst, fever
• If in doubt about pregnancy.

You should consult in the following days:

• In case of unusual pain or unusual appearance of the discharge
• In case of cycle disruptions.

Throughout their lives, starting in adolescence, women are advised to consult a gynecologist once a year to discuss contraception and prevention. This can be an opportunity to discuss period pain and report any changes observed.

What are the differences between endometriosis and painful periods?

Dr. Jean-Michel Morel reminds us: “Endometriosis is an abnormal ectopic location of the endometrium, that is to say, a displacement of the endometrium to organs other than the inside of the uterus; the ovaries, the intestine, the vagina, the rectum… This disseminated tissue is subject to the influence of hormonal variations just like the uterine endometrium. The most obvious symptom is pain: pain during menstruation, but sometimes also during sexual intercourse, urination, or defecation. When menstruation lasts a long time and causes pain beyond the usual sphere, great fatigue, or discomfort, when the pain does not subside with conventional treatments, it is necessary to consult your doctor or gynecologist. Endometriosis must be detected as early as possible to avoid a deterioration in symptoms and quality of life.”