Indicators of 'Bad' Menstrual Cramps

Menstrual cramps are a frequent problem amongst women. As high as 50% of menstruating women report cramps of some degree while about 14% of women between 20 and 35 years have symptoms so severe they miss school or work. Many women do not seek medical care for menstruation cramps or dysmenorrhea. The reason is because most of them have primary dysmenorrhea which have been an ongoing problem since menarche and they have learned 'how to handle it' with self-care and seek medical care whenever needed. The mistake which every woman should avoid is to delay seeking medical care thinking the cramp is 'just like the others'. There are some causes of dysmenorrhea which should not be missed because early treatment would be needed to provide the most effective intervention. Any delay in seeking medical care by mislabeling a specific disease of the genital tract as just ‘primary’ could result in disease progression and more complications to deal with. Secondary Causes Of Menstrual Pains There are two types of menstrual pain-primary and secondary. Primary cramps are those that do not have any identifiable medical cause and often begin shortly after menarche. They are the most frequent especially amongst adolescent girls. Secondary cramps are cramps caused by an identifiable underlying disease of the genital tract. Every woman should endeavor to know how to suspect an underlying secondary cause of her cramps especially if she has been having primary cramps. Secondary menstrual cramps may occur in a woman with known primary cramps and it is even easier for such women to think the current pain is just like the usual cramps. Common causes of secondary cramps include fibroids, endometriosis, pelvic inflammatory disease(PID), ovarian cyst, tubo-ovarian abscess or even an intrauterine contraceptive device. PID is a very common cause and often due to the chlamydia or gonorrhea. Indicators of a Possible Secondary Dysmenorrhea The indicators below do not make a diagnosis of any of the causes of secondary menstrual cramps but should serve as warning signs to seek medical evaluation. They include

• Onset of menstrual cramps in the 20s or 30s, after relatively painless menstrual cycles in the past.
• Associated infertilityrn
• Heavy menstrual bleeding or irregular cyclesrn
• Painful sexual intercourse( Dyspareunia)
• Vaginal discharge especially if it is offensive with yellow or green coloration.
• Pain that is not responding to the usual pain-killers especially the nonsteroidal anti-inflammatory drugs (NSAIDs)
• Sudden change of intensity and/or location of the usual menstrual cramp.