Dysmenorrhea

Cyclic pain associated with menses.


Dysmenorrhea is painful menstruation and is the most common of all gynecologic
complaints, and the leading cause of absenteeism of women from work, school,
and other activities. In addition to identifiable pathological causes, number
of constitutional factors may lower pain threshold thus appearing as worsening
dysmenorrhoea. Common factors include anemia, an increase in obesity, chronic
illness, overwork, stress in general, diabetes, and poor nutrition. Two
forms of dysmenorrhea can be identified:

  1. Primary dysmenorrhea not related to any definable pelvic lesion.
    This usually begins with the first ovulatory cycles beginning in most cases
    before the age of 20. Primary dysmenorrhea is associated with nausea in
    50% of patients, vomiting in 25% of patients and stool frequency in 35%
    of patients. The pain is low and crampy recurring in waves that probably
    correlate with uterine contractions. The pain usually occurs a few hours
    before bleeding, comes to a peak intensity within a few hours, and dissipates
    within 1-2 days. It generally occurs over the midline, and is relieved by
    the onset of good menstrual flow.


  2. Secondary dysmenorrhea related to the presence of pelvic lesions
    secondary to organic pelvic disease such as endometriosis, salpingitis and
    PID (pelvic inflammatory disease), post surgical adhesions, etc. Secondary
    dysmenorrhea begins up to a few days before menstruation and lasts several
    days after the onset of flow. Often it is lateralized to one side, and it
    does not characteristically peak and diminish as clearly or quickly as primary
    dysmenorrhea. It’s onset is later in life in women who have not had primary
    dysmenorrhea, however it can be superimposed onto a pre-existing case of
    primary dysmenorrhea. The I.U.D. may cause such pain problems.


Actions indicated for the processes behind this disease :

Anti-spasmodic herbs will ease the muscle spasms that
are the immediate cause of pain.

Nervines will help associated psychological tension or anxiety.

Diuretic remedies would be indicated if the dysmenorrhoea was of
a congestive nature accompanied by water retention.

Uterine Tonics provide the basis for any healing work in this body
system..

Hormonal Normalizers would be indicated if the diagnosis suggests
a pivotal contribution by hormonal imbalance.



System Support :

This will depend upon the diagnosis of cause.


Specific Remedies :

As there may be different underlying causes for this all too common problem,
a number of remedies have been called `specifics’. Remedies that are of
value in the whole range of etiologies are :


Cimicifuga racemosa Dioscorea villosa Scutellaria spp.

Viburnum opulus Viburnum prunifolium


One possible prescription for Dysmenorrhea :

Viburnum prunifolium

Scutellaria spp.

Cimicifuga racemosa equal parts 5 ml taken as needed



This supplies the following actions :

Anti-spasmodic (Viburnum prunifolium, Scutellaria
spp., Cimicifuga racemosa
)

Nervine (Viburnum prunifolium, Scutellaria spp., Cimicifuga racemosa)

Uterine Tonic ( Cimicifuga racemosa)



One possible prescription : Dysmenorrhea associated pelvic lesions

Viburnum prunifolium

Dioscorea villosa

Cimicifuga racemosa equal parts 5 ml taken three times a day



This supplies the following actions :

Anti-spasmodic (Viburnum prunifolium, Dioscorea villosa,
Cimicifuga racemosa
)

Nervine (Viburnum prunifolium, Cimicifuga racemosa)

Uterine Tonic ( Cimicifuga racemosa)



The addition of Dioscorea villosa will provide a more reliable anti-spasmodic
impact if a physical problem is present. This prescription will support
but not replace whatever treatment is necessary for the underlying
problem.


Broader Context of Treatment :

Dietary and supplemental approaches are well known, but unnecessary if the
appropriate herbs are used. Psychological issues can be fundamental here.
Low tolerance to the sensation of uterine contraction may be learned
behavior. If mothers never complained of painful periods, only 6.8% of daughters
complained of dysmenorrhea, conversely 29.6% of daughters of dysmenorrheic
mothers also had the symptom. However other studies dispute this association.
(Of course! This is the joy of statistics for the Ph.D. candidate.)

David L. Hoffmann BSc Hons MNIMH Written by David L. Hoffmann BSc Hons MNIMH

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