Dysmenorrhea is perhaps the most disruptive aspect of heavy menstrual bleeding (HMB), marked by severe cramping and pelvic pain during menses that interferes with a woman’s quality of life. Current estimates report that 50-90% of women suffer from dysmenorrhea, making it the most common condition shared with gynecologists.1 In fact, the World Health Organization (WHO) named chronic pelvic pain a “neglected reproductive health morbidity” due to the multifaceted and debilitating impact it has on a woman’s ability to carry out normal tasks during her period.2
Similar to excessive bleeding, dysmenorrhea is difficult to quantify and empirically evaluate in clinical practice.3 In order to determine pathological nature, clinicians often use quality of life (QOL) scales as the standard metric to analyze how menstrual cramping affects factors such as physical health, psychological well-being, social engagement, and functional ability.4 On the whole, patients with dysmenorrhea present with significantly lower QOL scores than patients without menstrual pain.4 Specifically, these scores include:
The hallmark of dysmenorrhea is pain, and up to 50% of patients with dysmenorrhea describe their pain as severe.1 Likewise, up to one-third of patients suffer from comorbidities such as gastrointestinal upset, fatigue, headache, reduce sleep quality, and poor mental health.1 Moreover, the pathophysiological changes during menses, including heightened prostaglandin production, can alter pain processing mechanisms and amplify pain sensitization in the central nervous system.4
The severe physical impacts of dysmenorrhea are exacerbated by high pain severity as well as a delay in diagnosis and treatment. According to one study, patients with dysmenorrhea are 2.5 times more likely to develop chronic pelvic and non-pelvic pain.5 Due to its chronic nature, the pain and side effects of dysmenorrhea have a compounding effect, especially for those who do not receive proper treatment for HMB.
Dysmenorrhea has a bidirectional relationship with mental health disorders.1 Not only does chronic, severe pain impact mood and increase stress, but certain psychological changes (depression, anxiety, and stress-related disorders) can magnify a patient’s perception of her reduced social activity and functional capacity.1 One meta-analysis found that women with dysmenorrhea were at a 1.72 times higher risk of depressive symptoms, with over one-quarter of subjects reporting depression events.6 Based on patient-reported physical and psychological scores, the damage to quality of life from dysmenorrhea is comparable to other chronic conditions, such as cystic fibrosis.1
Due to debilitating pain, patients with dysmenorrhea often cannot participate in social activities, hobbies, or family/relationship engagements. One study of over 1,800 participants found that dysmenorrhea impacted the ability to engage in work, school, and social activities in up to 89% of patients, with 10-20% of patients reporting an extreme impact on these functions.7 In addition to severe menstrual cramping, 93% of these patients experienced non-pelvic symptoms, including mood changes, bloating, constipation, and diarrhea — symptoms that further impacted their ability to maintain an active social life.7 Reduced social engagement, as seen in most dysmenorrhea patients, can heighten feelings of isolation, causing even greater damage to mental health and wellness.
Dysmenorrhea not only impacts quality of life as a whole but day-to-day functioning as well. Patients face functional limitations both at home and in the workplace, struggling to perform household tasks and maintain workplace productivity. One survey found that 13.8% of women report absenteeism during their periods, with some having to stay home almost every cycle.8 Likewise, more than 80% of respondents report presenteeism, with a 33% loss of productivity equating to 8.9 total lost days of productivity.8 Based on physical, social, and mental complications, the quality-adjusted life year loss of dysmenorrhea mirrors type 1 diabetes, asthma, atopic eczema, and chronic migraines.1
Dysmenorrhea wreaks havoc on every aspect of a patient’s life. That’s why, according to market research, 86% of women suffering from menorrhagia define treatment success as a normalization of their periods in addition to relief from menstrual cramping.9 As an FDA-approved endometrial ablation device, Cerene employs cryotherapy to treat HMB by decreasing blood loss and significantly reducing dysmenorrhea. Through cryoablation with nitrous oxide, OBGYNs can use Cerene to deliver a safe and well-tolerated ablation procedure that reduces dysmenorrhea in 86% of patients,† helping women experience a higher quality of life and live life with little to no interruptions.
Interested in learning more about how Cerene can deliver the much-needed relief your patients are looking for? Learn more at https://cerene.com/healthcare-professionals/
† Improvement reported one year after treatment for patients reporting severe/very severe period pain
Important Safety Information
Cerene® Cryotherapy Device is indicated to ablate the endometrial lining of the uterus in premenopausal women with heavy menstrual bleeding due to benign causes for whom childbearing is complete. Pregnancy following the Cerene procedure can be dangerous; therefore, contraception must be used until menopause. The Cerene procedure is not for those who have or suspect uterine cancer; have an active genital, urinary or pelvic infection; or an IUD. As with all surgical procedures, there are risks and considerations associated with the use of the Cerene Cryotherapy Device. Temporary side effects may include cramping, nausea, vomiting, vaginal discharge and spotting. For detailed benefit and risk information, consult the Cerene Instructions for use (IFU) or your healthcare professional. Learn More