[Click! Health] Today is 'Wol-gyeong Day'... Is it okay to ignore persistent menstrual pain?

On the 28th, World Menstruation Day, advice was given that if menstrual pain continues even after menstruation has ended, it is advisable to consult a gynecologist.

[Image courtesy of Ewha Seoul Hospital]

Menstrual pain, commonly known as dysmenorrhea, is a periodic lower abdominal pain occurring during menstruation. According to domestic reports, about 80% of menstruating women experience menstrual pain.

According to Professor Park So-yeon of the Department of Obstetrics and Gynecology at Ewha Womans University Seoul Hospital, menstrual pain can be classified into primary dysmenorrhea and secondary dysmenorrhea depending on the cause. Primary dysmenorrhea is periodic pain without accompanying gynecological abnormalities and is considered normal menstrual pain, while secondary dysmenorrhea is menstrual pain caused by gynecological diseases.

Professor Park advised, "If menstrual pain occurs after the age of 20, or if the pain has recently worsened, if the pain starts before menstruation begins and continues even after menstruation ends, or if pain occurs accompanied by menorrhagia, there is a possibility of secondary dysmenorrhea associated with gynecological diseases, so gynecological consultation is necessary."

Secondary dysmenorrhea is not the only concern. Even women without problems in the uterus or ovaries may experience severe menstrual pain that makes daily life difficult due to excessive increase of prostaglandins secreted from the endometrium during menstruation, causing periodic contractions of the uterine muscles and ischemic pain. In this case, the most effective treatment is nonsteroidal anti-inflammatory drugs (NSAIDs), which are recommended to be taken during the menstrual period (2-3 days).

Professor Park said, "NSAIDs are the most commonly used treatment for primary dysmenorrhea, but for patients who do not achieve pain relief with this treatment, combined oral contraceptives or intrauterine devices may be helpful," adding, "In addition, various treatments such as heat therapy, dietary therapy, vitamins, herbal medicine, herbs, exercise, and behavioral therapy are also proposed."

The normal menstrual cycle for women is 21 to 35 days, the duration is 2 to 6 days (average 4.7 days), and the amount of menstruation is 20 to 60 ml (average 35 ml). If a woman who has been menstruating skips her normal menstrual cycle three or more times and has no menstruation, or if a woman who has been menstruating has no menstruation for more than six months, she should visit a gynecologist for secondary amenorrhea. Changes in menstrual volume are also problematic. The normal number of sanitary pads used per day is about 3 to 5, tampons absorb about 6-15 ml, and sanitary pads absorb about 1-994 ml of menstrual blood.

Professor Park explained, "If the amount of menstruation suddenly increases in women of reproductive age, uterine diseases such as endometrial polyps, adenomyosis, uterine leiomyomas, or endometrial hyperplasia can be suspected," and added, "If the amount of menstruation suddenly decreases, it is necessary to check for possibilities such as physical changes due to age, effects of medications such as analgesics or steroids, or menopause."

Meanwhile, May 28th every year is World Menstruation Day, a commemorative day designated in 2013 by the German non-profit organization 'WASH United' to improve awareness about menstruation. The date May 28th was chosen to represent the average duration of menstruation being '5 days' and the cycle returning every '28 days.'

Professor Park So-yeon, Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital. [Photo by Ewha Womans University Seoul Hospital]