Primary Dysmenorrhea
Dysmenorrhea or painful menstrual periods is a common complaint with many women and adolescent girls. It is characterized by cramps and pain in the lower abdomen. Dysmenorrhea can be broadly classified as Primary and Secondary. While primary dysmenorrhea is identified with menstrual cylcles, secondary dysmenorrhea can be traced to pelvic diseases such as endometriosis, pelvic inflammatory disease, lesions and other causes such as IUD or uterine fibroids. Primary Dysmenorrhea usually surfaces with early ovulatory cycles and can start in the teens or 20s. Primary dysmenorrhea is not indicative of any abnormal condition. Accompanying symptoms are vomiting, diarrhea, nausea and abdominal bloating. It is noticed that symptoms of primary dysmenorrhea reduce after pregnancy and in latter years. Pain can be a dull ache or spasmodic and cramping. Since the uterus goes into spasms to expel the endometrial tissue during menstruation, it leads to pain and cramps when the cervical passage is narrow. Pain radiates to the lower back and thighs.
A physician will conduct a pelvic examination to check for any possible growth, lesions or abnormalities.
Those with a history of dysmenorrhea are usually advised to take medications a couple of days prior to menstruation. Adequate rest, good diet and exercise play a role in relieving the symptoms of dysmenorrhea. Mild analgesics and non-steroidal anti-inflammatory medications can relieve the pain and discomfort. Often oral contraceptives are prescribed to regulate the hormones and alleviate the symptoms of dysmenorrhea.
Hysterectomy
Hysterectomy is the surgical removal of the uterus that can sometimes save the life of a woman. Hysterectomies are usually performed abdominally or vaginally. Laparoscopic hysterectomy is also performed in some cases.
Reasons for hysterectomy
Gynecological cancer: Cancer of the uterus or cervix usually necessitates removal of the uterus and cervix. Endometrial cancer, cancer of the uterus or cervix or fallopian tubes usually requires hysterectomy surgery.
Endometriosis: In some cases of severe bleeding following endometriosis, a hysterectomy surgery is advised. This is the second leading reason for hysterectomies.
Fibroids: While most fibroid tumors can be treated by non-surgical methods, hysterectomy surgery may be the only permanent solution.
Uterine prolapse: When the uterus moves from its usual place down into the vagina, it can affect other organs such as the bladder. This can happen due to childbirth, obesity, loss of estrogen after menopause and weak pelvic ligaments and tissues.
Other reasons for going for a hysterectomy surgery range from heavy or irregular menstrual periods to dysmenorrhea. Severe pelvic inflammatory disease can sometimes necessitate a hysterectomy.
Types of hysterectomy surgery
Total hysterectomy involves removal of the cervix and uterus. It is known as Oopherectomy. Partial hysterectomy is a surgical procedure to remove only the upper part of the uterus, leaving the cervix in place. This type of hysterectomy is referred to as supra cervical hysterectomy or subtotal hysterectomy. Radical hysterectomy involves removal of the uterus, cervix, upper part of the vagina and the supporting tissues.
Hysterectomy surgery performed prior to menopause can bring about severe and prolonged symptoms as compared to natural menopause. A woman can experience bone loss, loss of libido, depression and anxiety. Many women may need hormone replacement therapy (HRT) following total hysterectomy where the ovaries are removed before menopause.
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