-- Dysmenorrhoea --
( Pain in abdomen during Menses )
Written by Dr. Sarika Doshi
Dysmenorrhoea is a condition of painful menstruation where the patient cannot perform her daily work. It is one of the most frequent gynaecological complaints of the young unmarried girls.
Types:
- Congestive
- Spasmodic
- Membranous
- Congestive Dysmenorrhoea
It is also called premenstrual, secondary or aquired dysmenorrhoea. It is due to pelvic faults i.e. some lesions in the pelvis.
Three main causes are:- Infection
- Aquired displacement
- Congestion,mostly due to chronic constipation.
- Infection:
Fallopian Tube is the most common site of infection to take place, but the ovaries are also involved.
Infection may be:- Puerperal
- Post operative
- Veneral
- From bowels,e.g.appendicitis
- Of adhesions of ovarian cysts,etc.,to the bowels.
- Through the blood stream,e.g.,Tuberculosis.
- Through the pelvis,e.g.,pelvic cellulitis,inflammation of tubes,ovaries,uterus etc.
- It is a common symptom of ovarian cyst,fibroids of uterus and polypi.
- Acquired displacement
It is due to Retroflexion of the uterus. Here, the fundus of the uterus lying over the veins produces congestion; thereby the endometrium becomes oedematous. The pain is thus premenstrual as well as menstrual often due to oedema of prolapsed ovaries. Prolaps, though rare, is also due to congestion and thus pain is premenstrual.
- Effects of chronic constipation
By toxaemia and loaded pelvic colon obstructing the lelt ovarian vein which causes congestion and vericosity of the broad ligament and ovaries.
Clinical features & symptoms:
- Pain starts 3-4 days before menstruation.
- Dull aching pain which is not so severe.
- Pain is worse by discharges.
- Profuse bleeding.
- It usually occures few years after painless menstruation.
- Feeling of weight and heaviness in the lower abdomen.