Menstrual Difficulties Information

Health condition

· Menstrual cramps
Most women experience menstrual cramps at some time in their lives. Cramps become problematic when they're severe enough to keep you from going about your day-to-day routine. You're more likely to have severe menstrual cramps if you have one or both of the following:

· A family history of painful periods
· Early onset of puberty (age 11 or younger)

If you have primary dysmenorrhea, cramps most likely began within three years after you started menstruating. They may persist through your 20s or until you deliver a child; then they're likely to decrease in intensity or go away entirely, for unknown reasons. With secondary dysmenorrhea, cramps may start or return later in life, but can begin anytime after you begin menstruating.

Signs and symptoms of dysmenorrhea, whether primary or secondary, may include:

· Dull or throbbing pain in your lower abdomen
· Pain that radiates to your lower back and thighs

Less common signs and symptoms include:
· Nausea and vomiting
· Loose stools
· Sweating
· Dizziness

What Cause Menstrual Cramps
No one knows for sure, but many experts believe that prostaglandins cause menstrual cramps (primary dysmenorrhea). Prostaglandins, hormone-like substances involved in pain and inflammation, trigger the uterine muscle contractions.

To create a nourishing environment for a fertilized egg, the female sex hormone estrogen causes your uterine lining (endometrium) to thicken every month. Soon after, a follicle — a tiny sac in your ovary that contains a single egg (ova) — ruptures and releases its egg (ovulation). If the egg becomes fertilized by contact with a sperm on its way to your uterus, the egg implants in the lining of the uterus. However, most often the unfertilized egg passes through your uterus and out of your body. Shortly thereafter, your uterus releases the lining, and your menstrual flow begins. To help expel its lining, your uterus contracts.

If you experience some or all of the following problems in the days before your monthly period, you may have premenstrual syndrome (PMS). The most common physical and emotional signs and symptoms associated with PMS include:

· Mood swings
· Tender breasts
· A swollen abdomen
· Food cravings
· Fatigue
· Irritability
· Depression
· Weight gain from fluid retention
· Abdominal bloating
· Tension or anxiety
· Crying spells
· Irritability or anger
· Appetite changes and food cravings
· Trouble falling asleep (insomnia)
· Joint or muscle pain
· Headache

But for some women with PMS, symptoms are so severe they're considered disabling. This form of PMS has its own psychiatric designation — premenstrual dysphoric disorder (PMDD). PMDD is a severe form of premenstrual syndrome with symptoms including severe depression, feelings of hopelessness, anger, anxiety, low self-esteem, difficulty concentrating, irritability and tension. As many as 50 percent to 60 percent of women with severe PMS may have an underlying psychiatric disorder.

What Causes PMS:
No one knows the exact cause of PMS, but there are contributing factors to the condition. Cyclic changes in hormones seem to be an important cause, because signs and symptoms of PMS change with hormonal fluctuations and also disappear with pregnancy and menopause. Chemical changes in the brain also may be involved. One clue to the cause may be traced to fluctuations of serotonin, a brain chemical (neurotransmitter) that is thought to play a crucial role in mood states, especially depression. Insufficient amounts of serotonin may contribute to other symptoms of PMS, such as fatigue, food cravings and sleep problems.

Occasionally, some women with severe PMS have undiagnosed depression, though depression alone does not cause all of the symptoms associated with PMS. Stress also may aggravate some of the symptoms, but alone isn't a cause.

Some PMS symptoms have been linked to low levels of vitamins and minerals like zinc, magnesium and calcium. Eating a lot of salty foods, which may cause fluid retention, and drinking alcohol and caffeinated beverages, which may cause mood and energy level disturbances, also have been identified as possible contributors to PMS.

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