Dysmenorrhea / Excessive, painful Menstrual Cramps
Dysmenorrhea, or painful menstruation, is the second most common gynecologic complaint, superseded only by premenstrual tension. Dysmenorrhea has been described as a discrete clinical entity, characterized by “labor-like” pains. The morbidity attending this condition is manifested in the voluminous hours lost in the workplace and schools as a result of dysmenorrhea. There are three types of dysmenorrhea. The first type is primary, characterized by the absence of an organic etiology. This most commonly occurs in adolescence, about 6 to 10 months post-menarcheal. Dysmenorrhea almost invariably is associated with ovulatory cycles. Thus, women taking oral contraceptives rarely experience dysmenorrhea. It is ameliorated in many women by pregnancy due to a decreased excitability of associated nerve fibers. However, some women experience an increase of primary dysmenorrhea after pregnancy, with some women continuing to experience dysmenorrhea throughout most of their reproductive years. Another type is classified as secondary dysmenorrhea, the pain being secondary to specific pathologies. These include endometriosis (the most common secondary cause and misdiagnosis of primary dysmenorrhea), ovarian cysts, adhesions, pelvic inflammatory disease, fibroid polyps, adenomyosis, cervical stenosis, and possibly uterine displacement with fixation. Membranous dysmenorrhea describes the third and most infrequent type. It is characterized by the passage of an intact cast of the entire secretory endometrium through a non-dilated cervix. The prevalence according to investigations by Moos, Coppen, and Kessel have noted moderate or severe dysmenorrhea in 45% of women surveyed. Additional studies have described similar prevalence rates. A survey of 113 patients from a family practice setting revealed the incidence of dysmenorrhea to range from 29% to 44% in any given two-month period. Extrapolations from currently available data indicate that approximately 10% of women of child-bearing age suffer from severe primary dysmenorrhea, rendering them unable to continue their normal work tasks at employment, school, or home. Budoff reports that dysmenorrhea is a major cause of work absence, totaling 140 million work hours annually. One study revealed that 10 to 15% of teenage girls missed one to two days of school each month due to dysmenorrhea.
A naturopathic approach to treating someone with dysmenorrhea would most often include addressing underlying estrogen dominance which clinically seems to be the most common contributor to a painful menses. Other nutritional deficiencies such as magnesium, or omega 3 fats may be considered, and botanical medicine – herbs like cramp bark, passion flower, valerian root, may be used to help manage symptoms. Dietary changes such as implementing a low glycemic index and/or anti-inflammatory meal plan are also often recommended.