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How is dysmenorrhea treated ?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
I'm a thirty six y/o female (two children 15 & 5). I've been having extreme breast tenderness about 2-3 weeks prior to my period which has been increasingly coming later and later (from the 1st to 5th to 11th to 18th). Last few cycles, my abdomen gets distended and feels sloshy, I have abdominal aching for two or more weeks before and really sharp cramping in my lower pelvis and upper thighs when my period starts, it's quite heavy for the first two days. Sometimes it's extremely painful to go to the bathroom. I leak clear, odorless fluid on regularly the 2nd and/or 3rd day of my period, sometimes this may come in a gush which is highly embarrassing. Occasionally I have a mild fever, swollen glands, feel dehydrated and am extremely tired. Even my husband has notice this all coincides with my cycle which I hadn't really thought about. My last ob/gyn visit a few months back and trans vaginal ultrasound was normal, at the time I mentioned I had a lot of abdominal aching in the lower left side but not anything else.
Posted Tue, 8 May 2012 in Menstruation and Miscarriage
Answered by Dr. Jasvinder Singh 31 minutes later

Thanks for posting your query. From the symptoms that you have described, it looks like dysmenorrhea to me. It is pain during menstruation that interferes with daily activities and this may precede menstruation by several days or may accompany it, and it usually subsides when the menstrual cycle is tapering.

This pain is felt in the right or left abdomen, lower back or thighs and is often accompanied by other symptoms like nausea, headache, dizziness, fatigue, tiredness and heavy bleeding during menstruation.

From your symptoms some important causes of dysmenorrhea need to be ruled out by investigations. These include endometriosis, adenomyosis, pelvic inflammatory disease or adhesion formations.

I suggest you to get the following tests done from a gynecologist:
1)     PAP smear
2)     Swab sample of the cervical discharge to rule out pelvic inflammatory disease.
3)     Laparoscopy

Till the time you get these investigations done, you should take adequate rest and sleep. Also bring dietary modifications like try to increase protein and decrease sugar and caffeine intake. You may need non steroidal anti inflammatory drugs like Ibuprofen after consulting your doctor. You may also need low dose oral contraceptives containing estrogen and progestin. Please get them prescribed from your gynecologist.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
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