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David Murana explains what the role of OH is in identifying dysmenorrhoea and referring employees for treatment.
Menstrual disorders can significantly impact on work attendance and performance (Palmer Brown and Hobson, 2013) and primary dysmenorrhoea has long been cited as one of the single most common reasons for periodic or short-term sickness absence among young women (Sundell, Milsom and Andersch, 1990).
OH practitioners can help manage and prevent short-term sickness absence caused by the condition. Short-term sickness absence here refers to an absence lasting up to seven days (Preece and Royles, 2013).
Primary dysmenorrhoea
Primary dysmenorrhoea is defined as "painful menstrual cramps without any evident pathology to account for them" (Dawood, 2006). Pain is usually in the lower central aspect of the abdomen (suprapubic region), but has the potential to radiate to the lower back or lower legs (Nasir and Bope, 2004). The pain has been associated with high levels of prostaglandins and leukotrienes in the menstrual fluid, which then causes abnormal uterine contractions (McEvoy, Chang and Coupey, 2004).
Onset of primary dysmenorrhea occurs during or not long after menarche, or first menstrual cycle (Dawood, 2006). The symptoms diminish with increasing age, and the highest is among the 20-24 age group, with a progressive decrease thereafter (Dawood, 1995). Pain is experienced by those affected for two to three days during ovulatory cycles (Dawood, 1981), and is most intense during the first 24-26 hours, when prostaglandin levels are high within menstrual fluid (Dawood, 2006). Sickness absence is likely to occur at this point when the pain is acute. Primary dysmenorrhea may be accompanied by nongynaecological symptoms such as nausea, bloating, vomiting, migraine and emotional symptoms (Clinical Knowledge Summaries (CKS), 2009).
Differences between primary and secondary dysmenorrhoea
Secondary dysmenorrhoea is the occurrence of painful menstruation with evidence of pelvic pathology such as fibroids, endometriosis, pelvic inflammatory disease and adenomyosis (Proctor and Farquhar, 2006). In this case, pain may persist after menstruation has ended or be present throughout the period. Gynaecological symptoms may appear (dyspareunia, vaginal discharge, intermenstrual bleeding, menorrhagia, postcoital bleeding) and also non-gynaecological symptoms (rectal pain and bleeding) (CKS, 2009). In addition, menstrual pain starts in women in their 20s or 30s, after previous relatively painless cycles (Smith, 1993).
Role of OH
Some would argue...