Why do women suffer from dysmenorrhea?

According to the 2021 Chinese Women's Health White Paper, 50% of women suffer from dysmenorrhea, mainly mild dysmenorrhea. Among them, 33% have moderate dysmenorrhea and about 10% have severe dysmenorrhea symptoms.

I believe that many women have experienced dysmenorrhea, and they may have heard this sentence: "It will be better after giving birth." So, can giving birth really cure dysmenorrhea? The answer is, not necessarily! So what should women do when they have dysmenorrhea? In addition to drinking more hot water and getting more rest, you need to know more.

1. Why do women suffer from dysmenorrhea?

Let's first look at what dysmenorrhea is. Dysmenorrhea refers to pain and distension in the lower abdomen before, after or during menstruation, accompanied by backache or other discomfort. It is usually located above the pubic bone in the lower abdomen (what we often call the lower abdomen), and can radiate to the lumbar sacral region and the inner thigh. In severe cases, symptoms such as nausea, vomiting, and cold sweats may occur.

According to the cause, dysmenorrhea can be divided into two categories: primary dysmenorrhea and secondary dysmenorrhea.

1) Primary dysmenorrhea, also known as functional dysmenorrhea, refers to dysmenorrhea that occurs 6-12 months after the onset of menstruation in women without organic lesions of the reproductive organs. This type of dysmenorrhea is generally caused by uterine spasmodic contraction caused by imbalanced secretion of prostaglandins in the uterus. During menstruation, if menstrual blood cannot flow out of the body smoothly, the prostaglandins secreted by the endometrium accelerate the contraction of uterine smooth muscles to help menstrual blood flow out, and this contraction will cause dysmenorrhea.

2) Secondary dysmenorrhea refers to dysmenorrhea caused by organic lesions in the pelvic cavity. Dysmenorrhea does not occur in the early stages of menstruation, but only occurs with age, such as endometriosis and adenomyosis. Secondary dysmenorrhea requires diagnosis and cause determination in the hospital, and treatment based on the cause.

****2. How to classify the degree of dysmenorrhea

1) Mild dysmenorrhea

There are pain symptoms, but it does not affect daily work and life. There are no symptoms such as nausea and vomiting, and there is almost no need to take analgesics.

2) Moderate dysmenorrhea

It has a certain impact on daily work and life, but there are almost no symptoms such as nausea and vomiting. Analgesics need to be taken , and the pain is significantly relieved after taking the medicine.

3) Severe dysmenorrhea

It has a significant impact on daily work and life, accompanied by systemic symptoms such as nausea and vomiting , and the effect of analgesics in relieving pain is not obvious.

**3.** Can having a baby cure dysmenorrhea?

What the previous generation often said, "Girls suffer from menstrual cramps, and giving birth to a child is a way of curing the disease," is actually not without reason.

Because there are indeed many people who have experienced a significant reduction in dysmenorrhea symptoms after giving birth, and some even no longer have dysmenorrhea. But there are also many people who say that they still have dysmenorrhea after giving birth, and it has not changed at all compared to before giving birth.

What is going on here? The reason is that having a baby will have completely different effects on dysmenorrhea caused by different reasons . Having a baby can greatly relieve primary dysmenorrhea . During the "ten months of pregnancy", a series of changes will occur in the female reproductive organs, the uterus will become larger, the reproductive tract will expand, the endocrine environment will change, the factors that cause dysmenorrhea will be eliminated, and the dysmenorrhea caused by related factors will be relieved or even disappear. Secondary dysmenorrhea is due to organic lesions in the pelvic cavity, such as endometriosis and adenomyosis.

Endometriosis, in layman's terms, means that part of the endometrial tissue that should have grown in the uterine cavity and the basal layer of the uterus has run outside the uterine cavity. Most of the ectopic endometrium is located in the pelvic cavity, but it may also invade any part of the body. When menstruation comes, the endometrium inside and outside the uterine cavity sheds and bleeds at the same time. The shed endometrium and bleeding outside the uterine cavity cannot be discharged through the vagina, but can only accumulate in the body, causing pain. During pregnancy and breastfeeding, due to changes in hormone levels, the ectopic endometrial lesions will shrink to a certain extent. After giving birth, dysmenorrhea may be slightly relieved, but as menstruation resumes, the lesions recur, and dysmenorrhea will still occur or even worsen .

It can be seen that having a baby can only partially relieve primary dysmenorrhea and temporarily relieve secondary dysmenorrhea caused by some organic diseases, but most secondary dysmenorrhea will recur even after a period of time after giving birth. Therefore, some people's dysmenorrhea symptoms are greatly alleviated after giving birth, while others do not change, because the causes of dysmenorrhea are different.

4. Dysmenorrhea, what should you do?

First, relax and don't be anxious . Many women will fall into anxiety before menstruation, and the negative emotions will aggravate dysmenorrhea. You should relax appropriately and treat it calmly. You can divert your attention with work or other entertainment activities, which can relieve dysmenorrhea to a certain extent.

Second, develop healthy eating and rest habits, maintain a reasonable nutritional intake , try to avoid eating raw, cold and spicy foods before and after menstruation, avoid staying up late, and welcome the arrival of menstruation with a healthy and energetic body.

Finally, clarify the cause of dysmenorrhea and actively treat it . When women experience dysmenorrhea, they should first go to a regular hospital for treatment, clarify the cause of dysmenorrhea, and treat it symptomatically. In short, whether having a child can relieve dysmenorrhea is not an absolute answer. Different causes of dysmenorrhea will lead to different conclusions. Only by clarifying the cause of dysmenorrhea and prescribing the right medicine can dysmenorrhea be effectively relieved.

Author: Hao Yanfang, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital

Review | Yu Qi, Chief Physician, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences

Source: Science Popularization Department of Chinese Medical Association, Science Popularization China