Lesson 6:-
Some women have significant pain and morbidity associated with their menstrual cycle. This can have a significant effect on their ability to play and train. It is a very common complaint among female football players and is often not well managed.
Dysmenorrhea can be classified as either primary or secondary based on the absence or presence of an underlying cause. Secondary dysmenorrhea is dysmenorrhea that is associated with an existing condition. In younger players, painful periods often occur without an underlying problem. In older women, however, it is more often due to an underlying issue (such as uterine fibroids, adenomyosis or endometriosis).
Further assessment or investigations are more likely to be needed in this group. The most common cause of secondary dysmenorrhea is endometriosis.
In most cases, the diagnosis of a dysmenorrhoea is based on a woman’s history and examination. In some cases, a pelvic ultrasound can also be helpful.
Learn more about the treatment of dysmenorrhea in football players.
Symptom: controlWhen faced with a player who has dysmenorrhoea, simple strategies can be used to try to manage their symptoms. NSAIDs are widely prescribed and can be used before training or matches. Heat (a hot water bottle for example) is another useful strategy – but is obviously not practical during training or matches.
Prevention: The oral contraceptive pill (OCP) can be used as a mean of trying to prevent menorrhagia. These treatments work by thinning the lining of the uterus, where prostaglandins are formed, which then reduces uterine contractions and bleeding. The OCP also gives the player the ability to control their menstruation and can also potentially improve the symptoms associated with their period. They may elect to skip the inactive pills if there is an important match or even which coincides with their period.
It is very important that the player’s suitability for the OCP be considered, that all possible side-effects are outlined prior to the medication being started, and that the contraceptive effects be clearly explained.
No negative effect on performance has been found from OCP use. 7 It is, however, important to realise that individuals respond to the OCP differently. As a result, the OCP use should not be started close to a major event.
Some players do not like taking the OCP, or do not have a satisfactory response from this treatment. Another option which might be considered is a Mirena intra-uterine device (IUD).
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