Cristiane Martins, From London for BBC News Brazil
Wia dis foto come from, Getty Images
Menstrual cramps na di discomfort or pain wey dey happun before or wen woman body dey comto di egg wey no fertilize (menstruation, wen you no get belle). Dis pain dey usually lasts up to three days, and many pipo tink say e dey common or e dey normal to get severe pain during dis time. But dat no be di case.
E fit even be one important sign of health problems, like endometriosis, adenomyosis, myoma, sexually transmitted infection, and pelvic inflammatory disease.
In general, dis conditions dey linked to cramps wey no go allow you do anytin, and e dey get effect one woman daily life to di point say e fit no allow her study or work well-well.
Wit severe pain, some women dey experience weakness, vomiting, sweating, dizziness and even some fit faint.
Make dem for relieve dis symptoms, dem dey use medication, home remedies (like hot water bags), medical leave, or physical exercise, for example.
But pain from causes like endometriosis and pelvic inflammatory disease dey need specialized care and treatment, wey fit even end di pain (instead of make e just relieve am wit each menstrual cycle).
Sabi pipo tell BBC say e good to pay attention to di signs and symptoms wey dey follow cramps, like irregular cycles, bleeding, discharge, vaginal pain and pain during sex.
And all of dem stress di importance of getting treatment from medical specialist and ask dem about di possible causes of dis health problem.
Understand how to identify normal or abnormal colic and wetin be di possible treatments for di different causes of dis intense pain. And whether e get any disease behind dem or not.
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Menstrual cramps na inflammation wey dey usually happun before di beginning of menstrual flow (period) and fit last for one day or two afta e start.
But dis one fit different from woman to woman, and from one menstrual cycle to another.
Di pain na usually sake of di blood vessels wey dey line di uterus dey compressed by di contraction to loosen di lining of di uterus and allow blood to comot.
Dis process dey interrupt di supply of oxygen to di uterus, and without oxygen, di tissues of di uterus release substances wey dey cause pain.
E fit also get help from prostaglandins, fatty compounds wey dey cause di muscles of di uterus to contract more, and dis dey increase di pain.
Dem dey also use contraceptive pill to fight dis pain because e dey reduce di thickness of di endometrium as e go produce a lower concentration of dis prostaglandin. In other words, e dey rduce contractions.
Dis cramp, di normal one, na di desquamation of di endometrium dey cause am. Wetin e mean? Di uterus na muscular organ wey dey contract all di time. How e dey contract dey different during di menstrual period.
No be all women dey experience dis cramps, and no be all women dey experience severe cramps. According to experts, 30-50% of women na im dey get painful periods.
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Na two key elements dem dey use identify problematic menstrual cramps: di impact on daily life and di need for medication.
Colic wey dem see as normal one na di one wey no dey interfere wit di patient daily life, doctor Liliane Diefenthaeler Herter, head of di Childhood and Adolescence Gynecology Center for Hospital da Criança Santo, tell BBC.
For Herter, mild colic no dey need medication, unlike moderate colic, wey go make you. "Miss class, go pale and get cold sweats from di pain, throw up or pass out from di pain, need intravenous medicine [for di vein]. All of dat dey normal."
Di São Paulo State Obstetrics and Gynecology Association say menstrual cramps wey dey make woman to take medication or even go to di hospital dey very strong and dem no dey consider am as normal.
"Normal colic na di one eventually wake up and her period start. She get little cramp, take one antispasmodic drug [wey dey fight muscle spasms], di kind swey dem dey sell for any pharmacy, get better and move about wit her life. ", gynaecologist Eduardo Schor, president of the Brazilian Association of Endometriosis and Minimally Invasive Gynecology explains to BBC News Brazil (SBE) explain am give BBC.
E get two types of menstrual cramps, wey dem dey call dysmenorrhea for medical vocabulary: primary (wey dey relate to adolescence) and secondary (wey dey associated wit diseases).
Dis type of menstrual cramps no dey related to abnormal cycles and injuries (wey no mean say dem dey calm and painless).
E start di day before di bleeding or di first day of di period, and last 2, 3 days at most. E no act like ogbonge pain," Herter tok.
Primary dysmenorrhea usually dey start a few months afta di "menarche (and no be at di same time as di first period).
Bernardo Lasmar, of di Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), explain say primary dysmenorrhea dey come from wetin dem dey call uterine hypercontractility.
“E no get polyp, no endometriosis, no myoma. Na di uterus wey dey contracts too much sake of series of substances wey dey release during di menstrual period”.
In general, dem no dey take primary dysmenorrhea seriously. E dey very common for teenagers to hear statements like "I too get colic and e pass", "you no get anytin to do am" and "afta you get children, afta marriage, e go dey better, e dey normal," Lasmar tok.
Di campaign of di American company Get Some Days, wey bin go viral on social networks as dem film men and women wit a period cramp pain simulator, na illustrative example.
For di videos, di men no fit endure di pain and dem shock to see how menstrual cramps be
Because dem no dey take dem very seriously, girls fit end up without proper treatment and stop to dey go to school or stop to dey go out wit dia friends, for example.
If dia routine don dey affected, gynaecologist suppose examine di problem.
Treatment dey usually involve nonsteroidal anti-inflammatory drugs and contraceptives, as e go thin di uterine lining and reduce di amount of prostaglandin (wey fit increase pain).
Studies also point to di benefits of physical exercise. Dat be, instead of giving up physical education, going to di gym, or doing other sporting activities, girls and women fit benefit from dis exercises to relieve symptoms.
Dis type of menstrual cramps usually dey lose im strength afta di age of 25.
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Dis second type of menstrual cramp fit last for di duration of di bleeding and usually manifest for adulthood (but teenage girls fit also suffer from am).
"If di cramps start afta di age of 25, if [di woman] neva get cramps before and she begin experience am, di probability say na secondary dysmenorrhea dey higher", Lasmar from Febrasgo explain am.
Di same na true, according to am, "if dis colic dey cause increased menstrual flow, pain during intercourse, pain in urinating during menstruation, pain during menstruation".
Besides dis pains, symptoms like nausea, vomiting, headache, weakness, irritability, mood swings, anxiety and fatigue dey follow secondary dysmenorrhea.
E dey important to find di causes of dis symptoms because e dey likely to dey related to one health problem, like endometriosis, adenomyosis, pelvic inflammatory disease, myomas, uterine polyps, sexually transmitted infections, malformations or even di use of a copper IUD.
Dem dey make di diagnosis anamnesis (history of all symptoms wey di patient don report, in addition to information like family history), physical examination and image examinations like transvaginal pelvic ultrasound in women wey dem already start dia sex life.
Dis examination fit reveal di existence of some of di causes wey dey listed above, like fibroids (tumors considered non-cancerous wey fit increase and make cycles more painful) and adenomyosis (wen di tissue wey dey line di uterus dey grow inside di uterus).
One of di most common na endometriosis, wey dey happun wen tissue wey dey similar to di lining of di uterus dey grow in other parts of di body (usually around di reproductive organs, intestines, and bladder).
e builds up monthly and then bleeds, but di blood no fit flow, as e dey cause buildup of trapped blood wey fit lead to lesions and scar tissue.
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Dis disease of still unknown cause affect between 6 and 10% of women. Di main symptom dey to dey get cramp during menstruation, but dis pain fit happun during defecation, urination or during sexual intercourse.
Dem no dey quickly diagnose am. Di Ministry of Health report say na more than 26,000 women dem see for SUS (Brazilian Unified Health System) wit endometriosis for 2021 and, on average, these women take eight to ten years to get di correct diagnosis.
In practice, many women dey end up getting used to living wit di pain, without proper treatment (wey fit involve medication to relieve symptoms or surgery to cure di condition). For dis reason, many of dem believe say colic wit incapacitating pain dey normal and common.
E get plenti reasons for dis delay in diagnosis, including issues of gender and race.
Studies show say dem dey examine di pain in women less often than in men, and for places like di US and UK, black women even dey for greater disadvantage than white women to get one correct diagnosis of pain. dis pains dey linked to endometriosis or other pathologies.
Pelvic inflammatory disease (PID) even dey more common than endometriosis. Dem dey confuse di two because dem fit involve pain both during sex and during menstruation.
According to di Ministry of Health, pelvic inflammatory disease na syndrome wey bacteria dey cause and e dey enter di vagina and reach di uterus, fallopian tubes and ovaries, cause inflammation.
“Dis condition mainly happun wen dem no treat gonorrhea and chlamydia infections,” di ministry say. The best form of prevention na to use di male or female condom.
"Acute pelvic inflammatory disease usually cause pelvic pain even without menstruation, but during menstruation, because di uterus swell, dysmenorrhea fit get worse," Herter tok.
Dem dey usually use antibiotics for treatment, but if dem no properly treat dis condition properly, di doctor explain say e fit lead to chronic pain, fertility problems or di need for emergency surgery if e progress. to an abscess.
Another possible cause of this second type of menstrual cramps (secondary dysmenorrhea) na obstructive uterine or vaginal malformation, dis be like di second most common cause for adolescent girls (afta endometriosis).
"Obstructive malformations usually dey cause pain from di menarche and e fit dey very strong. For dis kain situation, an evaluation with a pelvic ultrasound dey essential to see some menstruation no hook inside di vagina (hematocolpos ), inside di uterus (hematometra), or inside di fallopian tube (hematosalpinx).If dis blood dey present, e no dey normal and further evaluation dey necessary to find di cause of di pain and plan di treatment," Herter tok.
Specialists generally say big part of prevention na to understand wetin di menstrual cycle be, monitoring how e look (duration, pain intensity, etc.), how e happun in your own body, to dispel all doubts about dis wit specialists and to tok openly wit sem about all treatment options. Self-monitoring is therefore very important to identify changes wey fit or fit no cause health problems.
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