The majority of us experience pain during our periods once in a while. Now, what if you have severe pain which is unbearable every single cycle? Ever wondered why it is happening? Are you the only one suffering from it? And have you heard people saying that you wouldn’t be able to conceive if you had painful periods? If yes, then this article is for you.
What is dysmenorrhea?
         Dysmenorrhea is severe pain during periods. Now there are two types in it: Primary (which occurs with no obvious cause) and Secondary (which occurs with obvious cause). The pain may start before the menses and it would persist during the menstruations and it may last even after the menses has stopped. It is accompanied even with nausea, vomiting, and diarrhea at times.
What’s the cause behind this?
         During periods hormones called prostaglandins are secreted which contract the uterus to push the blood out of the body. Sometimes when this hormone is excessively secreted it not only contracts the uterus but also the surrounding blood vessels. Contraction of the blood vessels cuts off the oxygen supply to the muscles in the uterus. When a muscle lacks oxygen it causes cramping. This is in cases where there is no cause for the pain you experience (primary).

There are some medical conditions that cause dysmenorrhea (secondary) such as:
* Pelvic inflammatory disease (Bacterial infection that has spread to the uterus)
* Adenomyosis (Condition where the lining of the uterus grows inside the muscle of the uterus)
* Fibroids (Non-cancerous tumors inside or outside the uterus)
* Cervical stenosis (Narrowing of the cervix) 
* Polyp
        
        Hence when you experience pain during periods consistently it shouldn’t be ignored as normal. Seek help from the gynecologist to rule out any other secondary conditions causing it.
But how would you know if your menstrual cramps are normal or something serious that needs medical help?
        If your menstrual cramps continue over two or three days every cycle and are accompanied by the following symptoms such as fever, vomiting, diarrhea, dizziness, or sometimes even fainting, and if it affects your day to day activities, seeking medical help as soon as possible is important.

Who is at risk of getting dysmenorrhea?
         While many woman can experience dysmenorrhea, the following makes a person have a higher risk of acquiring it:
* Smoking and alcohol consumption 
* Being underweight or overweight 
* Having periods before the age of 11 
* Nulliparous women (who have never gotten pregnant before)
So does dysmenorrhea cause infertility?
         Well, the answer is both yes and no. In the case of primary dysmenorrhea (where there is no cause), it doesn’t affect your fertility in any way. In the case of secondary dysmenorrhea (where the pain is due to obvious cause) the pain itself doesn’t affect the fertility but the condition causing it does. For example, In the case of Dysmenorrhea due to PID (Pelvic Inflammatory Disease) the pain doesn’t cause infertility but there is scarring of the reproductive organs due to PID which in turn causes infertility. To conclude, the obvious answer is dysmenorrhea perse will not cause infertility, but the causal factor of dysmenorrhea may contribute to infertility. 

You might have one question in mind now, whether you can intercourse with dysmenorrhea? 
         You might think that intercourse during painful periods will squeeze your uterus more causing more pain. It's wrong. In Fact when a woman has an orgasm during painful periods it eases her menstrual cramps. The reason behind that is Oxytocin (The hormone released during intercourse and orgasm which is found to suppress the pain).
Now let’s get into some statistics:
         20 percent of women experience primary dysmenorrhea while 91 percent experience secondary. According to a study, about 51.8 percent of the women revealed that dysmenorrhea is affecting their daily life. This is more common especially in students around the age of 17-18. 15 percent of the dysmenorrhea is due to endometriosis, 1.03 percent is due to adenomyosis and 13 percent is from other medical conditions.

Tips to manage dysmenorrhea:

* Rest 
* Use a hot pack or even keep a hot water bottle on the lower back as well as the tummy
* Massaging your tummy as well as the lower back region 
* Doing yoga or pelvic floor exercises regularly helps 
* Try acupuncture 
* Doing breathing exercises and certain relaxation techniques 
* Hot bath or shower
* Last but not the least, Medication
Positions that help with dysmenorrhea:
         The best position to sleep with dysmenorrhea is called ‘’Fetal position’’. So how to position yourself? Roll on to one side, and tuck in your arms and legs  like how a baby sleeps in the womb. Curling up like this eases pressure on your abdominal muscle thereby reducing pain. Another position is to keep a pillow or roll towel and place it under your knees while lying down straight. This position increases blood flow to the uterus and relieves pain. 
         While sitting, keep a pillow on your back with your spine in a neutral position, meaning you shouldn’t slouch too much nor sit too straight. Sit back in the chair with knees on the ground. Your hips and knees should be at 90 degrees with each other. 
         Many of you might think that you shouldn’t be standing or walking or staying active when you have painful cramps since it aggravates the pain. It’s completely a myth. Researchers have found that standing and walking increase blood flow more than when you lie down or sit and thus help in relieving the pain. Stand with your hips little bent forwards. You can even bend fully forwards trying to touch your feet with your hands. Holding this position for a minute or two is an excellent way to relieve your cramps.
Is the food you eat related to dysmenorrhea in any way?
         Yes, there is a serious correlation between nutrition and primary dysmenorrhea. According to a study, 60 percent of the women who skipped a meal every day experience dysmenorrhea. Foods such as chamomile tea, dark chocolate, curd, fennel seeds, mint, and nuts release small quantities of dopamine and serotonin in  the blood thereby reducing the cramps. Ginger works as an excellent anti- inflammatory agent in helping with dysmenorrhea. Avoid sugary foods, caffeine, fried and salty foods, dairy, carbonated beverages, and processed food since all these cause bloating and increase your blood pressure leading to worsening of your cramps.   Though home remedies, yoga, and diet help in relieving the period cramps, seeking medical help is very important, especially in case of secondary dysmenorrhea. Secondary dysmenorrhea if left untreated for years could get complicated and may end up in a way that you need surgery. Seeking early treatment is the key to cure dysmenorrhea.