Doctors are finally treating menstrual miseries
It has many names: period, monthly, that time, my friend. But for many women the most apt description is the curse. For about half of all women of child-bearing age, menstruation is a monthly misery that causes intense physical and mental discomfort. In the U.S. alone, menstrual problems result in the loss of 140 million hours of work a year. Menstrual pain, says Pathologist Laurence Demers of the Milton S. Hershey Medical Center in Hershey, Pa., "probably is the most common cause for absence of women from the work force."
Yet despite its impact, menstrual distress rarely has stirred medical interest. Some attribute the neglect to sexist bias by a male-dominated medical Establishment. Says Family Practitioner Penny Budoff of the State University of New York at Stony Brook: "Many physicians act as if pain is women's due and getting rid of it is almost sacrilegious." A more basic reason may be that doctors have been unable to explain the link between a bewildering array of physical and psychological problems and a normal physiological event. As a result, women have been urged to cope as best they can with bed rest and aspirin, or they have been labeled neurotics and offered tranquilizers. Says Psychiatrist-Endocrinologist Ronald Norris of Boston's Tufts University School of Medicine: "When there's no obvious injury, physicians tend not to be sympathetic." Neither is the public. According to a poll conducted for Tampax, 22% believe that menstrual pain is psychosomatic.
There are signs, however, of a shift in attitude. It stems in part from studies showing that the gripping pelvic cramps as well as the headaches, backache, nausea and diarrhea suffered by many women during their monthly flow may be caused by prostaglandins. These potent chemicals, produced by the body, help regulate functions such as blood pressure, blood clotting and reproduction. Says Demers: "Some prostaglandins made by the uterus precipitate the contractions that are necessary for menses and labor. But when they're produced in excess, the uterine muscle cramps." Carried through the bloodstream to other parts of the body, the prostaglandins trigger additional discomfort.
Some drugs inhibit prostaglandin production. Oral contraceptives, for example, are effective but inefficient. Says Budoff: "You have to take 21 days' worth of pills for 24 hours' worth of relief. And then there are the dangerous side effects" (increased blood pressure, a greater risk of stroke and cardiovascular disease). Aspirin is helpful against mild pain. Most favored today are three drugs used against arthritis: ibuprofen, naproxen sodium and mefenamic acid.
Less understood than menstrual cramps is the premenstrual syndrome. Days or even two weeks before menstrual bleeding begins, many women experience tenderness and swelling of the breasts, migraine headaches, abdominal bloating and acne. They become lethargic, irritable and depressed. Researchers contend that severely distressed women are apt to have accidents, abuse their children or commit suicide or violent crime.