Q: I am 17-year old girl and I have been suffering from severe stomach pain and vomits during my periods. I sometimes also feel pain in my back. I don’t like eating even my favourites things and it happens only on the first day. Sometimes the pain remains for the whole day even after I take Buscopan plus.
I haven’t seen any doctor yet and look forward for you to help me out. What are the preventive measures and what role does diet play in this? I also have a problem that my hands and feet sleep very quickly. I think I am not overweight because my weight is 44kgs and my height is 5’3”.
I don’t like drinking milk or tea but I am fond of coffee, does that have to do something with the above mentioned problem?
A: The problem you have described is called Dysmenorrhea or painful menstrual periods. Most women have some crampy pain with their periods, especially as teenagers. The pain can begin just before the period or at the beginning of period and often lasts one to three days.
Other symptoms include lower abdominal cramping, with pain often radiating to lower back and inner thighs, nausea, altered bowel habits (diarrhoea or constipation), abdominal bloating etc. It is important to know if you had this problem since the onset of periods or did it start later in life. Painful periods from the age of onset usually mean that there is nothing seriously wrong. Young age, family history of dysmenorrhea or attempting to lose weight independent of body mass index are risk factors for developing this condition, but it has been seen to improve after childbirth.
The most common treatment is to take painkillers like mefenamic acid or ibuprofen at the onset of cycle. If these do not help, you should contact your doctor who may suggest nutritional supplements or birth control pills after ruling out a serious pathology through a detailed history, physical examination and maybe tests like ultrasound.
Preventive measure suggested for relief of painful periods include regular exercise to increases muscle tone and strengthening the pelvic floor to reduce menstrual pain. Others include smoking cessation and avoidance of excessive caffeine consumption.
A low-fat, vegetarian diet might reduce dysmenorrhea in some women by its effect on serum sex-hormone concentration and activity. Increasing the intake of omega-3 fatty acids may be of benefit by their anti-inflammatory action. Vegetables, fruits, and legumes and fish are typically low in total fat, but their content of omega-3 fatty acids, relative to other fats, is often high.
You are underweight (BMI of 17.18) so you need to improve your calorie intake, take a balanced diet and improve your weight. Finally consultation with a trained family physician will be a good idea. Dr Aisha Ambreen
AKUH
Q: I am 27-year-old male. I have been smoking for ten years but for a year now I am suffering from rapid heart beating, and sometimes while sleeping I become unconscious and I am not able to wake up. I consulted a heart specialist, he told me that my heart is weak and he suggested Harten 50mg tablet but know this tablet is not working on me any more. I wish to know can I exercise or play any physical game to improve my condition?
A: Along with raising your risk of lung cancer and other diseases, the mixture of tar, nicotine and carbon monoxide in tobacco smoke increases the risk that your arteries will harden, which restricts blood flow to the heart. Smokers have more than twice the risk of having a heart attack as non-smokers. According to the American Heart Association, smoking is the biggest risk factor for sudden cardiac death. Smoking can also leads to fast and irregular heart beats which is partly your problem. I am not sure what do you mean by getting unconscious during sleep.
I strongly advice you to quit smoking. You need to see a cardiologist who will arrange 24 hours heart monitoring for you. You can certainly do physical exercise once your heart doctor is happy with your heart. Dr Syed Salim Mujtaba
Liaquat National Hospital
Identities of the questioners are being withheld on request.
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