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DEALING WITH MENSTRUAL CRAMPS | Philstar.com
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Health And Family

DEALING WITH MENSTRUAL CRAMPS

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Every month, female adolescents and adults alike have to contend with the discomfort and inconvenience brought about by their menstrual period. For some, it is 'a walk in the park' - having no considerable effect on their day to day routine. For others, it can spell major aches and pains, interfering with their normal activities.

Menstrual cramps, also known as Dysmenorrhea - a medical term for painful periods, is characterized by abdominal pain stemming from uterine cramps during a menstrual period, and can be categorized into two types. The first and more common type is Primary Dysmenorrhea, which usually starts within 3 years of the onset of menstruation. The pain, in most cases, is due to the normal hormonal changes that takes place during the menstrual period. This type affects approximately 50 percent of women and it is severe in about 5 to 15 percent. Primary Dysmenorrhea may become less severe with age and after pregnancy. However, with Secondary Dysmenorrhea, the pain is usually brought about by underlying gynecological disorders, such as fibroids, endometriosis, adenomyosis, or a pelvic infection. This type is less common and affects one fourth of the women who have dysmenorrhea. A check-up with your gynecologist would be recommended here.

The pain experienced when having menstrual cramps or dysmenorrhea may vary considerably. Some women may feel a dull pain in their abdomen or back, while others may have severe cramping abdominal pain. Typically, the pain is at its worst at the beginning of the menstrual period, which often subsides in a day or two as soon as the menses start to flow. In some cases, women may also experience headaches, dizziness, constipation or diarrhea, nausea, vomiting, and sometimes, even an urge to urinate frequently. The premenstrual syndrome symptoms of irritability, nervousness, depression, and abdominal bloating may also persist during part or all of the menstrual period. Sometimes clots or pieces of bloody tissue from the lining of the uterus are expelled, causing pain.

Dysmenorrhea is very common, with the majority of cases being mild and not requiring any medical attention, unless the condition is a symptom of an underlying disorder. Again, in such case, it would be advisable to visit your gynecologist for a more thorough examination.

If the pain is mild, simple analgesics or pain-relief tablets can be used. However, for more severe acute pain, some patients may choose to use a traditional pain reliever such as an NSAID (Non-Steroidal Anti-Inflammatory Drug) like ibuprofen, aspirin, diclofenac, naproxen, etc. Although they are very effective in relieving pain, statistics in the United States reveal that those taking NSAIDs - 70% experience some form of gastro-intestinal side effect such as nausea and heartburn, while 30% are likely to incur stomach and intestinal damage like perforations, ulcers and bleeding, especially when used long term. Traditional pain relievers like NSAIDs tend to cause gastric irritation, because NSAIDs inhibit or block both COX-1 and COX-2 prostaglandins. The COX-2 prostaglandin is responsible for pain, whereas the COX-1 prostaglandin is needed to protect the stomach lining.

On the other hand, your doctor may also opt to prescribe a new class of pain relievers called Coxibs like rofecoxib, which inhibits or blocks the hormone that causes the pain, without causing Gastro-Intestinal (GI) side effects. Coxibs, also known as Cyclo-oxygenase or COX-2 inhibitors, are designed to block only the COX-2 prostaglandin. This action results in effective pain relief while sparing the patient from the stomach discomforts commonly brought about by traditional NSAIDs.

That is why Dr. Lyra Ruth Clemente-Chua, Obstetrician-Gynecologist at the Medical City Medical Center recommends Vioxx (rofecoxib), a coxib that can effectively provide pain relief for Primary Dysmenorrhea without comprising the patient's stomach lining, avoiding side effects like nausea, heartburn, bloating, belching, and other more serious gastro-intestinal problems. This she believes will provide high patient satisfaction.

For comments and insights, please write to Pain Management Information Agency (PMIA) P.O. Box 3485 Makati, fax 892-3968 or e-mail at paincare@pmia.com.ph. PMIA was established primarily to increase public awareness and understanding of pain and to recommend appropriate medical and practical ways to manage and control pain.

COX

COXIBS

DR. LYRA RUTH CLEMENTE-CHUA

DYSMENORRHEA

MEDICAL CITY MEDICAL CENTER

MENSTRUAL

PAIN

PAIN MANAGEMENT INFORMATION AGENCY

PRIMARY DYSMENORRHEA

SECONDARY DYSMENORRHEA

UNITED STATES

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