Myths and facts about menstrual pains

 Dysmenorrhoea (painful menstrual cycle) occurs in many women. There are also very many old myths about it that tend to mislead people or keep people from injuring themselves. In this report, Medinat Kanabe speaks to a doctor about dysmenorrhoea, its myths and facts.

Dr Harrison Otamere is Head of Department, HOD, Human Physiology, College of Medicine, Ambrose Alli University, Ekpoma, Edo State.  He defines dysmenorrhoea as cramps at the supra pubic region of a woman’s body (below the belt) that occurs before or during menstruation.

He said although not all women experience it, a good number of women do. Otamere then goes on to explain that there is primary and secondary dysmenorrhoea. “For primary dysmenorrhoea, there is no particular cause you can pin down to say this is the reason but there are some risks factors, however, for secondary dysmenorrhoea, there is something wrong with the uterus or the woman’s reproductive system.”

He added that “For primary dysmenorrhoea, you can only identify risk factors, you are just looking at its possibility, you cannot say this is the cause. For example, if the woman bleeds for too long or starts too early and for a woman that smokes cigarettes it can be primary dysmenorrhoea. For this type, after the menstrual cycle, it stops but if the pain is so much that the woman cannot bear it, we just give some pain relief and it will subside.”

But for secondary dysmenorrhoea, he said the doctor can identify to some extent the cause of the problem. “The commonest is the Pelvic Inflammatory Disease, PID, that is when the woman has an infection in the reproductive system and if the woman has cervical sinuses (if the cervix is too narrow), but that is very rare.  Then there is endometriosis which is having endometrial tissue where they are not supposed to be or abnormal growth inside the uterus which is adenomyosis.”

Dr Otamere disclosed that another thing that can cause secondary dysmenorrhoea is when some women visit a surgeon; the doctor may inadvertently create what is called asherman’s syndrome, which is the damage of the endometrium beyond the basal layer. This can result in dysmenorrhoea.

He reiterated that for secondary dysmenorrhoea, there must be a cause and the doctor concludes after a proper history of the person is taken. “We ask the woman questions; if she is honest the doctor will be able to ascertain where the problem is coming from. If it is PID and it is not treated, it can affect her. Asherman’s syndrome too can affect her. These are situations that can threaten a woman’s reproductive career if not treated.”

He then advised that if a woman is having dysmenorrhoea, she should see a doctor and answer his questions truthfully. “We will want to know whether the woman has an infection, we will also want to know whether she has had an abortion before because what we are trying to rule out is the possibility of an asherman’s syndrome that can lead to damage of the endometrium and can lead to gumming together of the womb, so all those things can cause dysmenorrhoea and can affect her reproductive system. Women should not resort to self medication but see a doctor when they are having dysmenorrhoea,” he said.

What we heard about dysmenorrhoea

Rachel Lakunmi is a 25-year-old student of the National Open University, NOUN, she said she was told that menstrual pain is as a result of excess sugar but she knew of people who don’t take sugar at all but have serious pains during their menstrual cycle so she didn’t believe the tale.

“I also heard that people who experience menstrual pains will have very easy child delivery in future compared to those who didn’t have menstrual pains. I never believed it. I have not confirmed it, but that is because I think it is not true.”

Christiana Ogbhe, a senior secondary school student, said she didn’t know anything but knows of one girl in her class who cries once every month. “I was always wondering why she used to cry. Many of us in class usually stared at her when she cried and we believed that she just wanted attention; we also felt her cry was because she likes boys too much. We always wondered why on earth she would let boys know she was having her period by coming to school to cry every month.”

Joana Olusegun, also in secondary school, said she heard that menstrual pain happens to about 70 per cent of women and that it stops after child birth. “I also heard that the woman must not take any medicine for the pains because if she does, it will affect her womb and she may not be able to have children in future, so she must go through with the pain and discomfort every month.”

On her part, Precious Greg said she knew about dysmenorrhoea at a young age and was ready for it. Fortunately for her, when it came it was without pains. “I had received classes on home economics and female reproduction before I started menstruating,” she said. Oladutemu Adelowo, a young journalist, also declared that she didn’t hear anything about dysmenorrhoea before she started menstruating.

Facts and myths of dysmenorrhoea

Responding to Lakunmi, Dr. Otamere said it is neither documented nor scientifically proven that sugar intake increases the pains of dysmenorrhoea nor that people who experience dysmenorrhoea have easier delivery.

Asked to confirm the myth that a woman must bear the pains until after her menstrual cycle if not her womb will get damaged from drugs, the doctor said it isn’t entirely true.

“If the pain is endurable, yes, she can endure but the drugs we usually prescribe is not the type that will affect the womb. What her mother is trying to do is to prevent self medication because what many do is self medicate, which may cause injury to the person. If they do this, they may not get the proper medication and the proper dosage, so the mother is just trying to protect her child. But if she is in the hand of the physician or specialist, we know what to give.”

On whether sex stops it, he said that is not correct. “I have not come across anything like that and, medically, I have not read up to that extent.”

When he was asked if child delivery helps to reduce or stop the pains, he said yes. “When you start giving birth, it can improve; it can improve with age too. We have seen very many cases like that.”

Asked to compare the pains of dysmenorrhoea and labour pains, he said: “If you know what labour is, you will know that it is not comparable to any pain but pain of burns, so dysmenorrhoea can never be as painful as labour pain. Dysmenorrhoea can be quite painful, but for some women when the cycle starts, it starts to reduce.”

On what a woman should do if she is vomiting and have dysmenorrhoea, he said: “She should be investigated for other things like malaria, typhoid, PIV and other ailments. Women should worry when they have secondary dysmenorrhoea and not worry if it is primary.”