Rwanda: Experts Warn Against Overuse of Painkillers During Menstrual Cycle

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Because of his long-term usage of diclofenac pills, Keza, a 32-year-old accountant in Kigali, is hospitalized due to renal failure. His use of the medication brought on this condition. She started using this analgesic as a teenager to reduce the painful symptoms of menstruation.

She was able to acquire the analgesics in big numbers and have them on hand as a first aid kit in case of extreme pain since they are readily accessible for purchase at any drugstore. This was even though the painkillers had not been prescribed to her by a medical professional.

A little over three months ago, I became ill with a fever and immediately went to the emergency room. My health continued to become worse even though I had finished the therapy that was recommended to me. I asked the physicians to take another look at my health, and even though they determined that I did not have malaria, I was not exhibiting any signs of recovery,” she reveals with an upset tone.
Menstrual cramps, or dysmenorrhea, are a typical source of discomfort for many women and girls throughout their monthly menstrual cycles. These cramps are experienced by a large number of women and girls each month. Some women only have slight discomfort, but others have terrible agony that requires them to use medicines to get respite.

However, medical professionals are quick to point out the possible risks associated with using nonsteroidal anti-inflammatory medicines (NSAIDs) over extended periods. Aspirin, ibuprofen, and naproxen are all examples of the family of pharmaceuticals known as NSAIDs. These medications are often prescribed to patients to alleviate inflammation, mild to moderate discomfort, and fever. However, these medicines have also been linked to certain users’ gastrointestinal issues, renal issues, and elevated blood pressure.

In the instance of Keza, the physicians suggested that she undergo a thorough medical check to identify whether there were any underlying issues. According to the findings, she suffered from renal failure, which suggested her kidneys were not operating as they should have been.

Keza expressed her surprise to The New Times, saying that she had not experienced any of the condition’s symptoms before its diagnosis, except some little swelling in her fingers and feet, which she had ignored.

Because she did not drink enough water to flush the toxins out of her body after taking an excessive quantity of diclofenac painkillers, the test results showed that her kidneys were damaged as a consequence of the medication, and she needed to undergo dialysis as a result of this condition.

When a person’s kidneys cannot function properly, they may need a dialysis procedure. “The procedure is not only uncomfortable but also pricey,” Keza stated.

Because of this, her family is presently doing a fundraising campaign to assist her in making the trip to India, South Africa, or Kenya to have a kidney transplant.

What causes abdominal cramping during your period?
The contraction of the uterine muscles is thought to be the root cause of dysmenorrhea, according to Dr. Kenneth Ruzindana, a specialist at the University Teaching Hospital of Kigali (CHUK).

The uterus undergoes contractions throughout the menstrual cycle, which assists in the shedding of the endometrium, also known as the uterine lining. According to him, these contractions are caused by chemical signals known as prostaglandins, which are created in greater quantities immediately before and during the onset and progression of menstruation.

“These prostaglandins are responsible for muscle contractions (to help expel blood) from the uterus,” explained Dr. Stephen Rulisa, a chief consultant of obstetrics and gynecology at CHUK and a professor of obstetrics and gynecology at the University of Rwanda. “In the process, it is this contraction that is felt as cramps,” Dr. Rulisa added.

According to Ruzindana, the uterine lining emits greater quantities of prostaglandins, hormone-like compounds, before and during menstruation. In the body, prostaglandins are responsible for various processes, including the stimulation of inflammation and the contraction of muscles.

Because of the elevated quantities of prostaglandins, the muscles of the uterus contract with a greater force than they would under normal circumstances. Ruzindana that these contractions assist in shedding the uterine lining that has grown up throughout the menstrual cycle. The pain and discomfort resulting from the contractions are often referred to as period cramps.

It has been shown that intense contractions of the uterine muscles might momentarily limit the amount of blood that flows to the uterus, which can further add to pain and discomfort. As he said, the sense of pain might be brought on by a decrease in blood flow, which can bring about an oxygen deficiency in the muscular tissues.

Ruzindana noted that the degree of period cramps may vary from person to person, elaborating that some people feel slight discomfort. In contrast, others may have far more powerful and incapacitating pain.

He said that hormonal changes, heredity, general health, and certain medical problems are some of the variables that might impact the degree of period cramps. Other causes include the presence of certain medical disorders.

It is typical to have some discomfort during menstruation; however, a medical expert should be seen if the pain is severe enough to interfere with everyday activities or is accompanied by additional symptoms such as heavy bleeding, nausea, vomiting, or fever.

In addition, Ruzindana said that medical professionals can diagnose any underlying issues and provide recommendations for suitable therapy to prevent period cramps.

When exactly do medications become dangerous to take?

Rulisa said that using painkillers is permissible; nevertheless, just like any other drug, using too much of it or taking too much of it might have adverse consequences.

For instance, many analgesics, like aspirin, may prevent blood from clotting or coagulating, which can lead to an increase in the amount of bleeding that occurs.

Ruzindana said several possible adverse effects and hazards are associated with the overuse of painkillers during menstruation, particularly those that are not prescribed.

He emphasized the need to use painkillers responsibly and according to the authorized dose and directions that a qualified medical practitioner supplied.

Ruzindana noted that over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may irritate the lining of the stomach and increase the risk of gastrointestinal problems such as stomach ulcers, bleeding, and gastritis.

In addition, taking an excessive amount of painkillers may burden the kidneys, particularly if they are used for a protracted length of time or in large dosages. He cautioned that this might cause harm to the kidneys or make issues that already existed for the kidneys worse.

According to Ruzindana, some medications, such as paracetamol, may cause harm to the liver if they are used excessively or mixed with alcohol. An overdose of paracetamol is a major health risk that may result in abrupt liver failure.

He elucidated that “regular overuse of painkillers can lead to tolerance, in which you need higher doses to achieve the same effect,” and even dependency, in which your body becomes dependent on the medicine. “Tolerance” and “dependence” are both caused by “regular overuse of painkillers.”

He emphasized that excessive painkillers might hide any underlying medical disorders that may be the source of menstruation pain and that this should be avoided at all costs. Instead of depending entirely on pain treatment, it is crucial to get to the bottom of what’s causing the pain rather than just masking the symptoms.

It is essential to confer with a medical expert to efficiently and safely control the discomfort associated with your period. According to Ruzindana, if the pain associated with your period is significant or regularly interferes with your daily life, they may advise on effective strategies for pain reduction and evaluate any possible underlying issues.

“It is essential that you take notice that you must adhere to the dose directions if you are going to utilize pain relievers that are available without a prescription. “I cannot stress how important it is to adhere to the recommended dosage or duration of use.”

Ruzindana noted that there are a variety of non-conventional approaches to treating menstruation discomfort, some of which include heat treatment, relaxation techniques, exercise, changes to one’s diet, and herbal therapies.

It is recommended that these choices be discussed with a healthcare professional. If over-the-counter medicines cannot give enough relief, your physician may suggest prescription drugs or other therapies.

Rulisa offers alternate advice: place a warm towel on the stomach, sip warm water, and concentrate on mild movements.

It was revealed to me by a gynecologist at the Deva Medical Centre in Nyarutarama named Dr. Shakhnoza Abdukhalilova that eating foods high in Vitamin E may help alleviate discomfort.

Because of its antioxidant capabilities, vitamin E lowers the oxidation of phospholipids, prevents the release of arachidonic acid, and prevents the conversion of arachidonic acid to prostaglandins. As a consequence, it has the potential to play a substantial part in reducing the intensity of dysmenorrhea.

She said that it has been shown that zinc may ease menstrual cramps and swelling and that omega-3 fatty acids, owing to their anti-inflammatory effects, may be useful in alleviating the discomfort associated with menstruation. Ibuprofen is a popular painkiller, and clinical tests done in 2012 and 2018 revealed that taking omega-3 fatty acids helped lower the amount of ibuprofen required to provide the same level of pain relief.

It is recommended by Dr. Abdukhalilova to drink herbal teas like camomile and turmeric, to remain warm, and to massage the stomach gently with essential oils since these things help to alleviate the pain and suffering associated with periods.

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