Menstruation accompanied by slight lower abdominal pain (dysmenorrhea) is common, right from menarche (first menstruation) which may gradually fade away after your first sexual contact or in some cases can continue up to your first vaginal delivery.
This pain can be considered as primary type of dysmenorrhea. This is due to the muscle spasm caused during menstruation and is called as spasmodic dysmenorrhea and disappears after enough muscle stretching during pregnancy during labor. Whereas in secondary dysmenorrhea, there is usually an underlying cause for the pain and its episodes may vary from disease to disease.
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As the first kind is temporary and needs less attention as compared to the first one, unless it hampers your daily chores, the congestive type (secondary) needs to be viewed seriously, not because of the pain, but due to the underlying pathology.
Before rushing to your family doctor in case you get a pain abdomen, there are few things you have got to keep in mind regarding your normal body functions and alarming symptoms.
Spasmodic dysmenorrheal has no specific cause, seen on the initial days of menstruation which slowly reduces with menstruation. But in case of congestive type of dysmenorrhea, the pain may be premenstrual, menstrual or post menstrual depending upon its cause. Premenstrual pain is that occurring prior to menstruation and post menstrual is that occurring after menstruation.
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It is very important to categorize your pain into premenstrual and post menstrual. If your pain is premenstrual in nature, and gets relieved by menstrual flow, you are likely to have PID (Pelvic Inflammatory Disease). It is a condition in which your pelvic organs, either gut related or reproduction are infected and inflamed due to an apparent infection which may be to the reproductive organs or any neighboring structures.
If your pain starts after menstruation, the first thing your physician will have to rule out will be a case of endometriosis. Endometriosis is a condition where a functional endometrium is formed inside in areas other than the uterus. Although it is mentioned as postmenstrual, there is a condition called triple dysmenorrhea, meaning premenstrual, menstrual and post menstrual which is typical to endometriosis. It is a clinical pathology which needs to be managed as soon as possible having complications following poor management. As stated right now, that it is to be viewed seriously there are other feature seen in endometriosis. You can remember it as a 5D disease, with features listed below;
1, Dysmenorrheal
2, Disorders of menstruation
3, Dyspareunia (painful coitus)
4, Dyschezia (pain while passing stools)
5, Dull aching pain abdomen
It also has an additional symptom of infertility in case of endometriosis. Menstrual type of dysmenorrheal is usually due to uterine fibroid or adenomyosis.
Uterine fibroids are benign tumors of the uterus that can be formed in different parts of the uterus, whose signs and symptoms may vary depending on its site and location. Adenomyosis is a disorder of the endometrium in which it grows into the myometrium.
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Before looking into the signs and symptoms and jumping into conclusions, you first need to have a thorough evaluation of your whole body rather than only reproductive or any single system evaluation.
The reason is simple. The clinical features you notice in a particular area or aspect of your body can be a signal of an underlying disease in any other part of your body and vice versa!
