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Pain During Menstruation: Treatment, Procedure, Cost and Side Effects

Last Updated: Jun 20, 2024

What is the treatment?

Menstrual cramps are actually painful sensations that affect a woman before and during the period of menstruation. Menstrual pain is also known as period pain or dysmenorrheal, which ranges from severe and extreme to dull and annoying. Usually, menstrual cramps begin after ovulation, which is the eggs being released from the ovaries and travelling down the fallopian tube. Pain generally occurs in the lower abdomen or lower back. It begins a day or two before menstruation and lasts for about 2 to 4 days.

Over-the-counter medication is known to treat several cases of menstrual cramps. Anti-prostaglandins reduce the cramps in uterus, lighten blood flow, and relieve discomfort. These medications consist of pain killers, such as naproxen or ibuprofen. These are a type of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs can be used alone for the treatment of menstrual cramps. In case, a woman is strong and healthy, a physician may prescribe certain hormonal birth control medicines to prevent ovulation and reduce the extremity of menstrual cramps. These work by thinning the uterus lining, the area where the prostaglandins form. As a result, this decreases the pain and cramps. Birth control pills can be taken continuously in some cases, without the 4 to 7-day break every month which is normally adhered to. In this case, there might not be any bleeding at all. In some cases the cramping is due to an underlying medical condition. Such cases may require immediate surgical treatment.

How is the treatment done?

Some of the menstrual cramps such as endometriosis, fibroids, ovarian cysts, or polyps can be treated via surgery. D & C is procedure known to remove uterine polyps. Laparoscopy is used for the treatment of pelvic endometriosis or ovarian cysts. Endometrial ablation is a procedure used to destroy the lining of the uterus. There is another surgical process known as hysterectomy which completely removes the uterus.

There are three options of surgery for the treatment of endometriosis. These are conservative surgery, radical surgery and complex surgery. The point of a conservative surgery is to remove or destroy the properties of endometriosis and it is usually done through a laparoscopy (keyhole surgery). In this surgery, the surgeon can either destroy the endometriosis using laser or heat, or cut it out (excision). Although surgery provides relief from the pain, it can even reoccur in time. A radical surgery is considered only when a woman has not responded to a conservative surgery, drug treatments, or is not planning to start a family. Radical surgery points toward a hysterectomy. Hysterectomy is performed under general anaesthetic and is associated with removal of the womb. Lastly, a complex surgery includes endometriosis, depending upon the severity of the patient’s condition. This surgery requires an experienced team of colorectal surgeons, and is usually performed via laparoscopy.

Who is eligible for the treatment? (When is the treatment done?)

A woman who is not thinking of starting a family in mere future is eligible for the surgical treatment of removing the uterus. Moreover, a woman who has not yet been able to respond to medications fulfills the eligibility criteria.

Who is not eligible for the treatment?

A woman who is expecting to start a family in future is precluded from receiving the treatment. Underlying medical conditions which are still not treated, make a woman an ineligible candidate. Patients with anemia and thalassemia cannot undergo the treatment.

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Are there any side effects?

Common side effects of the medications involved in menstrual pain relief include, a growth in the thickness of lung secretions, stomach cramps and drowsiness. There have been seen a lot of rare side effects also. These are acute liver failure, decreased blood platelets, decreased white blood cells, acute pustular eruption on the body, blood disorder, blurred vision, vocal cord swelling, hepatitis caused by drugs, dizziness, nervousness, confusion and many more.

What are the post-treatment guidelines?

Patients need to follow up on a routine consultation with their gynecologist, in case of pelvic pain. Exceptions include some infectious entities such as endometriosis or abscesses. If the patients do not undergo a regular medical care, a primary doctor appointment is also suitable. A vegetarian diet with low fat is advised by the doctor after surgery. This diet comprises of food items induced with vitamin E, pyridoxine and magnesium. In addition, acupressure, acupuncture, agonists, beta-adrenergic, antileukotrienes and isometric exercise have been advised for therapeutic use in this particular setting. Continuous topical application of low-level heat has been proven beneficial for most patients.

How long does it take to recover?

It takes 4 days to recover from the medicinal dosages. In case a woman has undergone surgery, it will take her 2 to 3 days to be released from the hospital and about 6 to 8 weeks for full recovery.

What is the price of the treatment in India?

Surgical treatment ranges between Rs. 80,000 to Rs. 90,000. On the other hand, cost of medications is not that high. It ranges between Rs. 200 to Rs. 5,000. Over-the-counter medications are prescribed by doctors in case the condition has not worsened.

Are the results of the treatment permanent?

The results of treating menstrual pain can never be permanent as it will occur simultaneously every month. It can only be prevented or reduced. Herb and vitamin intake may help in this case. A proper diet may also prevent menstrual cramps to a great extent. In case the uterus is permanently removed under a surgery, only then is the treatment of menstrual pains permanent.

What are the alternatives to the treatment?

There are various home remedial measures to treat menstrual cramps. For instance, soaking in a hot bath provides a great deal of relief and relaxes you immensely. Applying heat to the lower abdomen with a hot water bottle is another alternative treatment method. Transcutaneous electric nerve stimulation (TENS) is a recommended remedy to treat menstrual pains.

References

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Written ByDr. Jayashri S MBBS,MS - Obstetrics and GynaecologyGynaecology
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