There are two types of dysmenorrhoea. The first type is primary dysmenorrhea, which usually occurs in young women since the first menstruation. Such this menstrual pain arise in the first days of menstruation, and further reduced in the next days. Typically, pain in primary dysmenorrhoea will be more decrease with increasing age, and improved after delivery.
The second type is secondary dysmenorrhoea, the cause is not prostaglandins produced through natural processes. Painful on this secondary dysmenorrhoea can occur before menstruation
started, and will increasingly painful on the following days- sometimes does not disappear
after menstruation. The reason most frequently is endometriosis, in which endometrium grows outside uterine cavity. The outside endometrium will also have to groe out.
Bleeding will cause pain, which arise before, during, and after menstruation. Another cause is myoma that are benign muscle tumors uterus, it can cause menstrual pain and excess bleeding. Or, Adenomyosis in where the inner lining of the uterus grows into the uterine wall. Other causes are inflammation pelvis.
From the history of the disease, pelvic examination, ultrasound examination and some
laboratory tests, usually can be determined types of dysmenorrhoea. Sometimes, required to peeping into the abdominal cavity with laparoscopic tools. Sometimes, on the secondary dysmenorrhea can be found specific cause and can be treated. But yet often times the cause can not be found.
The treatment principle of dysmenorrhoea,if the cause can be determined so the specific treatment focused on eliminating or at least reduce the cause. If not, then the treatment, especially for reduce the pain. Most painful menstruation can overcome by medicine that sold in store. But when the pain is very disturbing and lasted more than 2-3 days, then should see a doctor.
To reduce pain, The most frequently used is the class of drugs NSAIDs (non-steroidal antiinflammatory drugs), which in addition it can block the production of prostaglandins that may also reduce symptoms of nausea and diarrhea. NSAIDs are most effective when taken early menstruation or pain during the initial only 1-2 days. The group of this drug does not allow for women suffering from disorders blood clotting, liver disease and heartburn.
The second drug that can be used to reduce menstrual pain is a hormonal contraceptive, such as the pill, patch, and IUDs. Hormones on contraceptives will be limiting the growth inner lining of the uterus, so that prostagalndin production is not too many. This hormone also may limit the growth of endometriosis and myoma, thereby also beneficial to reduce menstrual pain in dysmenorrhoea the secondary.
In secondary dysmenorrhoea due to myoma, therapeutic options are myoma removal (even all her womb) through the operation. Meanwhile, the endometriosis can be done laparoscopic surgery for the outside endometrium. In cases of severe dysmenorrhoea, sometimes uterus removal should be done.