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  • Treatment of menstrual pain: drug addiction or hysterectomy?

  • The off plan strategies

  • The breast cancer prevention diet: avoid omega-6 fats

  • Menopause and hormone replacement therapy (hrt): the benefits of hrt

  • Controlling our reproductive destiny: technology advances faster than ethics

  • PMS: the ingredients of a healthy diet

  • Normal menstrual cycle

  • Alexander procedures for pregnancy and labour: the lunge

  • 30-week visit: ante-natal cardiotocography (foetal heart monitoring)

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TREATMENT OF MENSTRUAL PAIN: DRUG ADDICTION OR HYSTERECTOMY?

My menstrual cramps make me feel as if I'm being cut with sharp knives without ever having had anesthesia. At first, doctors put me on birth control pills, but there's a history of breast cancer in my family, so I stopped them. I've seen many doctors and they always prescribe Percodan or Demerol or Darvon for the pain, but I want to get rid of it, not sedate it. I'm thirty-one and I have two children now and I don't want to be walking around half asleep when they need me. The latest doctor I've seen wants to do a vaginal hysterectomy, but having recently heard you speak, I'm beginning to wonder if surgery is such a good idea. I need help now before I become seriously addicted to all these drugs I've been given. I've really come to rely on them for relief and I'm scared.

—R.C.

Toronto, Ontario Canada

Pain is the body's signal that something is wrong and a doctor needs to evaluate what the causes of the pain might be. In the case of menstrual cramps, the cause can be a surplus of prostaglandins, resulting in primary dysmenorrhea, or uterine infection, an IUD, fibroid tumors, endometriosis (a condition in which the menstrual blood is pushed back through the Fallopian tube into the abdominal cavity)—all of which bring on secondary dysmenorrhea. A doctor must take his time to assess the problem, but doctors often don't understand that they're facing women with real pains. Even doctors' wives have been short-changed by husbands who give them addictive painkillers for their menstrual cramps.

Many doctors' wives are hooked on tranquilizing, narcotic drugs because their husbands are anxious to stop their sufferings fast. Doctors often don't take he time to comprehend the physiological phenomenon that is going on within a woman's body, even within the women they love. So every female is going to have to stand up for herself.

The woman who wrote this letter is probably suffering from an overabundance of prostaglandins and she might be helped by Motrin or Anaprox. These drugs have been FDA-approved for use in both the United States and Canada. It seems that I'm repeating the names of these drugs often, but right now they, and Ponstel, are the only ones available. During the next several years we'll probably see more, maybe even better, antiprostaglandin drugs, but these are the ones we have today. All women need to know this.

A hysterectomy should be the last possible treatment for any condition. A uterus is not just an unnecessary organ. The uterus and ovaries may even have functions we don't know about today. They do produce hormones, and if the uterus is removed, the blood supply to the ovaries is decreased and that may bring on other problems. Ms. C.'s cramps, as described, are horrific, but a new, rather expensive medication called Danocrine (danazol) would stop her menstruation for a while, and give her reproductive organs a rest and her body a chance to recuperate from her monthly attacks. Danocrine, which is taken every day, may be an alternative for this woman and should be used if a pelvic "rest" is called for. If the cramps should recur, they will probably cause only minor discomfort which can be curbed with antiprostaglandins. If possible, hysterectomy should be avoided forever.

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Women's Health

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