Local Studies

Primary dysmenorrhea is quite common, affecting 55% of women in the Philippines, with

10-15% of them suffering from a disabling pain, severe enough to make them absent from work

or from class.

It usually starts in early adolescence and becomes less severe at late age or after

pregnancy. The pain is due to the contraction of the uterus when there is significant reduction in

the blood supply of the endometrial lining. It must be emphasized that the pain occurs only

during the menstrual cycle in which there was previous ovulation and egg was released from the

ovary. The pain may worsen as the uterine lining tissues shed and pass thru a narrow cervical

canal. Other factors that may worsen the pain are retrovertal uterus (uterus that tilts backward),

lack of exercise and even psychological stress.

A lot of my female nursing friends have requested that the column deals with their once-

a-month “parusa” as if being a descendant of eve is a stigma that deserves some kind of

punishment. The topic is definitely not within our expertise so we ran to a former student who

was now an accomplished obstetrician-gynecologist Dr. Jo Ann Ballesteros-Badua, immediate

past chief OB-Gyne of the SLU Hospital of the Sacred Heart a willing, accommodating

consultant on the matter.

Dysmenorrhea is a condition of painful menstruation and there are two classifications:

primary- which occurs soon after menstruation and declines with age and after childbirth,

secondary- which develops later in life and is a result of endometriosis or other pelvic diseases.

The development of cramps when the uterus goes into spasm is caused by high levels of

mediators- like fatty acid called prostaglandins. (Sumpio, 2008)

 Primary dysmenorrhea usually sets in within a year or two years after the first

menstruation. The pain typically develops when the bleeding starts and continues from 32 to 48

hours. (Cababa, 2005)

Dysmenorrhea occurs much less often in women who do not ovulate. For this reason, oral

contraceptives reduce painful periods in 70-80% of women who take them when the pill is

stopped, women usually get the same level of pain they had before they took it. The primary

form usually occurs in females who have begun menstruates. It may disappear or become less

severe after a woman reaches her mid- twenties or gives birth because childbirth stretches the

uterus. The cause of menstrual cramps is thought to be related to hormone like substances called

prostaglandins. These are chemicals that occur naturally in the body. Certain prostaglandins

cause muscles in the uterus to create spasms. (CosmoMagPh, 2005)