Health Guide

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Congestive dysmenorrhea is premenstrual pain in lower abdomen or back and is generally seen among sedentary women. Congestive dysmenorrhea usually occur between three to five days (some times more than five days) before starting of menstruation and is always relieved by menstrual flow (pain goes away once menstruation starts).

Congestive dysmenorrhea should be regarded as a symptom of pelvic disease at first instance and there may be some pelvic abnormality in patient with congestive dysmenorrhea. Disease like pelvic adhesion, salpingo oophoritis (inflammation of ovary and Fallopian tube), parametritis etc almost always produce congestive dysmenorrhea and this may be due to hyperaemic ovaries and covered by adhesion from inflammatory lesions. These lesions become tense during premenstrual period of menstrual cycle and cause pain. Congestive dysmenorrhea is also common symptom of certain diseases like myomas, adenomyoma, acquired retroversion of the uterus, chocolate cyst of ovaries etc. But all the patient of congestive dysmenorrhea does not have an organic disease and an example of congestive dysmenorrhea without an organic disease is premenstrual tension or premenstrual congestion syndrome.

Some patients with congestive dysmenorrhea get symptoms (pain and discomfort) referred to one of the iliac fossa usually left iliac fossa. Pain and discomfort is usually accompanied by disturbance in bowel habit (generally constipation and rarely diarrhea) and flatulence distension of abdomen (upper colon) which is due to spasm of some part of colon. Colon is palpable as a tender part of intestine in this situation. Diagnosis can be confirmed by barium enema and radiology. Frequently laxatives are taken with the mistaken idea that purgation will relieve the spasm but in reality it aggravates the condition.

The right management of this type of congestive dysmenorrhea is correct diet (avoiding carbohydrates), avoid purgatives and some anti spasmodic medicines that acts on bowel like Buscopan. These patients of congestive dysmenorrhea should be encouraged to do regular exercise as the patients are generally sedentary office worker.