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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 cycles, 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.

Primary Biliary Cirrhosis

Primary biliary cirrhosis (PBC) is a condition caused by inflammation of the small bile ducts in the liver, leading to cirrhosis. Inflammation later spreads and destroys liver cells. This leads to scarring and toxicity arising out of trapped bile. This condition is not caused by alcohol or drug. It is an autoimmune disorder that is more likely to affect women than men.


Primary biliary cirrhosis advances over the years and often the patient may not experience any symptoms and may not look ill at all. Persons suffering from PBC tend to feel severe fatigue. There may be severe itching on the skin. Hyperpigmentation may be noticed on the skin of a person suffering from PBC. There may be thyroid problems and joint pains. Dry Eye syndrome is also noticed. Another symptom of Primary biliary cirrhosis is enlarged abdomen. The patient may notice easy bruising and bleeding. Pain is felt in the abdomen and liver areas. Renal stones and gallstones may develop. As the condition worsens, there may be softening of the bones making them susceptible to fractures. Jaundice is often noticed in patients suffering from Primary biliary cirrhosis. It also results in digestive problems and infection of the urinary tract.


An alkaline phosphatase activity test can help diagnose PBC. Liver function tests and other diagnostic tests such as serum cholesterol and lipoproteins are also conducted. A liver biopsy can aid the physician in understanding the severity and extent of liver damage. Any thyroid malfunction is corrected with thyroid hormone. Corticosteroids are prescribed to patients suffering from Primary biliary cirrhosis. Cholestyramine may be effective in reducing the itching. Liver transplantation is the final alternative when there are signs of liver failure such as GI bleeding, jaundice and accumulation of fluid in the abdomen.

  • Quit smoking
  • Drink plenty of water and fluids
  • Reduce alcohol, caffeine
  • Increase Calcium and Vitamin D supplements

Amenorrhea

Amenorrhea is a condition where a woman of reproductive age does not get her regular menstrual periods. Amenorrhea can be primary or secondary Amenorrhea.

Primary Amenorrhea: This condition occurs when the first menstrual period of a girl is delayed or does begin by 16 years. This could be due to delay in pubertal development. Birth defects in the reproductive system can often lead to primary Amenorrhea as also tumor in the hypothalamus or pituitary gland. Abnormal chromosome or genetic defects can be a cause. Hypothyroidism, hyperthyroidism, Cushing's disease and congenital heart disease can be a cause for primary Amenorrhea. Often the cause is not known. Symptoms include acne and excess body hair, headaches and vision problems.

Secondary Amenorrhea: This kind of Amenorrhea occurs in women during their reproductive period. Secondary Amenorrhea is a situation where the menstrual period is absent for about 3 months. This is most often due to pregnancy and breastfeeding. Symptoms of secondary Amenorrhea are mood fluctuations, goiter, vaginal dryness, depression and nausea.

If any systemic condition is the cause for Amenorrhea, appropriate treatment often leads to the start of menstruation. Often anorexia or over exercising can lead to Amenorrhea. Endocrine disorders, hormonal imbalance, PCOS and use of birth control pills often lead to Amenorrhea. Other causes for Amenorrhea include malfunctioning ovaries and stress. Women who complain of Amenorrhea are given a physical examination by the gynecologist. Blood tests for prolactin and T3, T4 and FSH are done. Other blood tests include test for serum progesterone. Pelvic ultrasound is done to check for any abnormalities.


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Collection of Pages - Last revised Date: November 22, 2019