How to Treat Dysmenorrhoea?

Menstrual cramps (dysmenorrhoea) are curable. Your physician may offer certain medications to relieve your pain. Sometimes, you may need surgery, if medications do not work well. Some home remedies and lifestyle changes also help manage the condition.

Medications

The following medications are considered for women with dysmenorrhoea.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs help relieve pain during your menstruation. Menstrual cramps occur due to a type of chemical substances called prostaglandins, which are secreted by the lining of the uterus (endometrium) during the menstruation. NSAIDs inhibit the production of prostaglandins and lessen the effect.

Your physician may recommend taking OTC (over-the-counter) NSAIDs like Naproxen or Ibuprofen. It should be started as regular doses at the day before your menstrual period to begin. Sometimes, your physician may offer prescription NSAIDs like Mefenamic acid. Aspirin is usually less effective. You normally need to continue NSAIDs for a couple of days. However, physicians recommend avoiding NSAIDs, if a woman has bronchial asthma, bleeding disorders, liver damage, Aspirin allergy, stomach ulcers, or certain stomach disorders.

Birth control methods

Certain hormonal contraceptive methods are widely used to manage dysmenorrhoea. They contain female hormones like progestogens and oestrogen. Oral contraceptive pills (OCPs), hormonal patch, vaginal ring, birth control implant, hormonal injection, and intrauterine device may help treat dysmenorrhoea. These hormones prevent ovulation and lessen the severity of dysmenorrhoea.

If you have dysmenorrhoea due to endometriosis, hormonal birth control methods may help relieve pain. Sometimes, your physician may offer a medication called the gonadotropin-releasing hormone agonist (such as Nafarelin and Leuprolide), which suppresses the functions of your ovaries. Gonadotropin-releasing hormone agonists (GnRH agonists or GnRH-A) may cause certain adverse effects like hot flushes, bone loss, and vaginal dryness. Usually, these medications are offered for a short period of time. They are unsuitable for teenagers. However, physicians may recommend them for teenagers with severe dysmenorrhoea, which doesn’t relieve with other medications.

Alternative treatments

Certain treatments such as Vitamin E, magnesium supplements, omega-3 fatty acids, Vitamin B1 (thiamine), and Vitamin B6 may be helpful, but there is little evidence.

Acupuncture therapy has been proved to be somewhat useful in relieving menstrual cramps.

Transcutaneous electrical nerve stimulation (TENS) may be helpful to manage menstrual cramps. It increases the nerve threshold for pain as well as the release of the natural painkillers called endorphins (endogenous morphine), secreted by certain parts of your brain (pituitary gland and hypothalamus).

Surgery

If other treatment options do not relieve menstrual cramps or if dysmenorrhoea occurs due to an underlying condition like fibroids or endometriosis, surgery may be required. Surgical procedures include the removal of the abnormal growth or interrupting the nerve pathways from your womb. The type of the operative procedure will depend on the underlying cause of dysmenorrhoea. Fibroids and endometriosis tissues can be removed surgically. However, endometriosis tissues may grow again following the surgery. Therefore, its outcome can be for a short period of time. Taking medications, including hormonal birth control following surgery may help prevent or delay the return of menstrual cramps.

A treatment known as uterine artery embolisation (UAE) can be used to manage dysmenorrhoea due to fibroids. In the UAE, certain blood vessels to the fibroid are blocked with embolic agents (small particles). Those particles are delivered through a flexible, slender catheter by an Interventional Radiologist. UAE obstructs the blood supply to the fibroid hence leads it to shrink and die. Complications of UAE include pain, infection, and bleeding.

The removal of the uterus (hysterectomy) may be carried out, if other treatment options have not relieved dysmenorrhoea and if the condition leading to the menstrual cramps is severe. Usually, hysterectomy is the last option.

Home remedies and lifestyle

Regular exercise also increases the release of endorphins, which help relieve dysmenorrhoea. Mild to moderate intensity physical activities like yoga, walking, swimming, and jogging are the best.

You can use a heating pad on the lower abdomen or soak in a hot bath. They are effective as OTC painkillers for relieving dysmenorrhoea.



Related Links:

Dysmenorrhoea (Menstrual Cramps)
Dysmenorrhoea: Risk Factors and Diagnosis
Do You Have Heavy Periods (Menorrhagia)?