Menstrual Difficulties Treatment

Usual cure

· For menstrual cramps
You may be able to reduce your discomfort from dysmenorrhea by using an over-the-counter nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen (Aleve, Anaprox). Self-care strategies also may help relieve discomfort. For severe cramping, your doctor might recommend low-dose oral contraceptives to prevent ovulation, which may reduce the production of prostaglandins and therefore the severity of your cramps.

You can also reduce the discomfort of primary dysmenorrhea. Once the pain begins, soaking in a hot bath or using a heating pad on your abdomen may ease your cramps. You also can make some lifestyle changes to improve your overall health and possibly decrease the severity of your cramps. Try following these tips:

· Exercise regularly. Exercise results in an increased release of endorphins, your body's natural painkillers.

· Get adequate rest. Your body may be less vulnerable to pain when you're well rested.

For secondary dysmenorrhea, you'll need treatment for the underlying cause. Sometimes a disease or condition, such as uterine fibroids or endometriosis, causes the pain. Treatment depends on what is causing the problem and how severe it is. Depending on the cause, treatment could include antibiotics to treat infection or surgery to remove fibroids or polyps.

In recent years, much has been learned about PMS. Lifestyle adjustments and treatments can help you reduce or manage your signs and symptoms.

Changing lifestyle
Managing your lifestyle can sometimes reduce the symptoms of PMS by making changes in the way you eat, exercise and approach daily life. Try these steps:

Change your diet -
· Avoid caffeine.
· Avoid alcohol.
· Eat smaller, more frequent meals each day to reduce bloating and the sensation of fullness.
· Limit salt and salty foods to reduce bloating and fluid retention.
· Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains.
· Choose foods rich in calcium. If you can't tolerate dairy products or aren't getting adequate calcium in your diet, you may need a daily calcium supplement or take a daily multivitamin supplement. See below:

- Calcium. Consuming 1,200 milligrams (mg) of dietary and supplemental calcium, such as chewable calcium carbonate (Tums, Rolaids, others), may reduce the physical and psychological symptoms of PMS. Regular, long-term use of calcium carbonate also reduces your risk of osteoporosis.

- Magnesium. Taking 200 mg of magnesium daily may help to reduce fluid retention, breast tenderness and bloating in women with PMS.

- Vitamin B-6. A daily dose of 50 to 100 mg of vitamin B-6 may help some women with troublesome PMS symptoms.

- Vitamin E. This vitamin, taken in 400 international units daily, may ease PMS symptoms by reducing the production of prostaglandin, hormone-like substances that cause cramps and breast tenderness.

Some women report relief of PMS symptoms with the use of herbs such as black cohosh, ginger, red raspberry leaf, dandelion tea, chaste tree berry and evening primrose oil. However, few scientific studies prove the effectiveness of herbs thought to help reduce the effects of PMS. Check with your doctor before taking any herb or dietary supplement.

Regular exercise routine -
Regular daily exercise can help improve your overall health and alleviate symptoms such as fatigue and a depressed mood. Engage in activities you may enjoy like brisk walking, cycling, swimming or other aerobic activity at least 30 to 60 minutes most days of the week.

Manage stress -
· Get plenty of sleep.
· Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).

Some of the more common complementary products and remedies used to soothe the symptoms of PMS also include:

· Natural progesterone creams. These are derived from wild yams and soybeans. Some women report that these creams relieve symptoms. No scientific studies prove their effectiveness.

Keep a record to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.

Medical Treatment
Your doctor may prescribe one or more medications for PMS. The success of medications in relieving symptoms varies from woman to woman. Commonly prescribed medications for PMS include:

· Nonsteroidal anti-inflammatory drugs (NSAIDs)
Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.

· Oral contraceptives
These stop ovulation and stabilize hormonal swings, thereby offering relief from PMS symptoms.

· Antidepressants
Selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac, Sarafem), paroxetine (Paxil) and sertraline (Zoloft), have been successful in reducing symptoms such as fatigue, food cravings and sleep problems. These drugs are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.

· Medroxyprogesterone acetate (Depo-Provera)
For severe PMS or PMDD, this injection can be used to temporarily stop ovulation. However, Depo-Provera may cause an increase in some signs and symptoms of PMS, such as increased appetite, weight gain, headache and depressed mood.

Treatment for severe PMS or PMDD is similar to that of PMS, but may be more intense.

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