Dysmenorrhea

Mar 31, 2020

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

"The fridge door fell off." My lunch hour began normally, if somewhat hectic. I hadn't packed a lunch but suddenly I had an errand list to complete. I jumped into the vehicle. At the first stop, I stuffed some fast food down my gullet. Next, I bought some Guinness at the liquor store. I truck dashed across the parking lot for sugar, milk and frozen broccoli at Safeway. I drove north on Main Street to White Dove. I needed super yeast for a bored buddy of mine in self isolation. I truck toured to the north end of Main and unloaded the supplies without getting within 6 feet of anyone. Back in the vehicle, I turned right at the courthouse and head home. It was now 12:50 pm. I had to be back at work by 1 pm. I ran into the kitchen to drop off the milk and frozen broccoli. My two housebound kids and my wife, who was trying to work from home, were standing around the fridge. It was Emily who told me, "The fridge door fell off." Being the ever caring and capable husband and father that I am, I put the milk and broccoli on the counter said, "I'm late" and left.

I'm sure many husbands and fathers are handy and can fix fridge doors. For me, it was astonishing that they even they fell off. By this point in our marriage, Doris has learned that she is the handy person in the house, because I am not. Whether they are handy people, welders, students, doctors or accountants, about one in three women have menstrual pain, heavy bleeding or other symptoms that interfere with their daily activities. That is a significant portion of the population that regularly have their quality of life effected.

Non-drug measures to treat menstrual pain include heating pads to the lower abdomen or lower back. And although counter-intuitive to someone in pain, a regular exercise routine can limit pain due to cramping. TENS machines (which stands for transcutaneous electrical nerve stimulation) are machine with sticky pads that send tiny electrical pulses into the skin. They are used to treat a variety of different kinds of pain, but they don't seem to be as effective as medication for menstrual pain.

Non-prescription medication for menstrual pain should start with NSAID's. Non-Steroidal Anti-inflammatory Drugs block prostaglandins which we believe are involved in menstrual pain. NSAID`s may even reduce heavy menstrual bleeding. The two over the counter NSAID`s most often used for menstrual pain are ibuprofen and naproxen. Neither one has been shown superior to the other, so women can choose whichever one they like best. NSAID's work best if they are taken on a regular schedule and started 1 to 2 days before each period. They should be continued regularly for at least 1 to 2 days during menses.

NSAID`s work better than acetaminophen containing products like Midol. Acetaminophen doesn`t work as well as NSAID's for menstrual pain because acetaminophen doesn't block prostaglandins. The other ingredients in medications like Midol including caffeine, pamabrom and pyrilamine don`t seem to be of much value either.

The most common prescription medication used for dysmenorrhea are contraceptives like birth control pills. Whether it is a birth control pill, patch or ring, the hormones in the contraceptives can reduce both menstrual pain and bleeding. Other options include using an extended cycle pill. An extended cycle pill has only 4 hormone free intervals per year instead of the traditional break every month. This allows for just 4 periods per year, so there is less overall pain and discomfort. Hormone containing IUD`s like Mirena can help dysmenorrhea even more than birth control pills again by decreasing the frequency and duration of menses.

There have been claims that supplements like vitamin B1, magnesium and fish oil all help dysmenorrhea. However, NSAID`s and contraception work better than any of those supplements.

There are some sentences that are difficult to comprehend. I mean you understand all the words in the sentence, but you never pictured them being put together in that way. For me "The fridge door fell off" is one of those sentences. I mean it's not "Inter-dimensional time travelers have shown up in Sifton and really enjoy Rhonda's jerky selection at the Mercantile Store," but I really didn't think fridge doors "fell off". On the good side, Doris discovered our fridge door is held on by two vertical pins. If you lift up the door and you can slide it onto those pins, and bing, bang, boom you have a working fridge door again. Doris has learned many things trying out working from home. She learned about virtual private networks to securely connect to the office, appliance repair and that your husband is quite useless when faced with a fridge door crisis and a deadline.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

 


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