Can Hysterectomy Be a Permanent Solution for Dysmenorrhea Subtypes?

The article Dysmenorrhea Subtypes Exhibit Differential Quantitative Sensory Assessment Profiles by Hellman et al. (2020) sought out to test the hypothesis if women with dysmenorrhea (DYS), dysmenorrhea with bladder hypersensitivity (DYSB), and bladder pain syndrome (BPS) have reduced level of bodily pain pressure pain threshold (PPT) and impaired conditioned pain modulation (CMP) which might indicate impairment of descending inhibition. In this study, patients experienced both dysmenorrhea and silent bladder pain (DYSB), comparing the results to healthy control groups (Hellman et al., 2020). In this study, the researchers did not conclude a valid solution to how women with severe bladder syndromes and pains can alleviate the pain they experience when they get their periods. The severity of the pain in women is severe; as a result, a new method of combating the challenge may need to be discovered in the long run.

One recent report by The Washington Post indicated that women's only choice at this stage in their life might be to go through a hysterectomy which is not an ideal solution for individuals who desire to have children in their life (Branigin, 2021). Though the only solution to the pain-relieving method of dysmenorrhea subtypes is hysterectomy, according to the report, some women are refused the treatment of hysterectomy based on the age of their healthcare providers. Furthermore, in the report, the women who experienced this reported that they felt motherhood was being pushed by their doctors more than their health (Branigin, 2021). Though doctor's responsibility is to their patient, the recent report and the women who experienced indicate otherwise in which the doctors refuse to perform hysterectomies to prioritize their reproductive health over their health. Counterintuitively, other research has indicated that doctors are more likely to give more hysterectomy to black patients even without the patients asking for it compared to white patients (Branigin, 2021). This could be debated in other cases, but the report shows that there may be race discrimination related to the white and black individuals undergoing hysterectomy.

Despite hysterectomy being the best option in pain relief for patients with dysmenorrhea, there are still some disagreements on its effectiveness from different scientific endometriosis communities. As a result, the surgical excision of a reproductive organ to alleviate one's pain is frowned upon by some doctors (Branigin, 2021). One reason for this is that some doctors still fear that endometriosis pain cannot guarantee that the pain will not show up in other organs after hysterectomy, which can be devastating not only for the doctors but also for the doctors also for the patient who risked their future life. Doctors' uncertainty toward the appearance of endometriosis pain in other organs stems from the fact that as long as a hormone stimulates the growth of the cells, the pain will appear. At this point, doctors in the OB/GYN field cannot identify (Branigin, 2021) precisely. In Hellman et al.'s 2020 research work and talk, this uncertainty and endometriosis pain dispersing in other parts of the female organ also exacerbate patients' pain.

Overall, the finding of this paper indicates the need for much more advanced procedure and treatment that works for all women without having them decide between their reproductive life and their pain management for their severe condition. The report further shows that there needs to be more research on pain dispersing on other organs of the women when and if they decide to undergo hysterectomy for their health. In addition, the report also sheds light on race discrimination in the medical field that needs to be addressed when treating women of all different backgrounds.

References

Branigin, A. B. (2021, April 20). Choosing between not having kids or pain: An endometriosis case is sparking outrage. The Washington Post. https://apple.news/ANE00QtxbRAmIRt8Le3EIWw

Hellman KM, Roth GE, Dillane KE, Garrison EF, Oladosu FA, Clauw DJ, Tu FF. Dysmenorrhea subtypes exhibit differential quantitative sensory assessment profiles. Pain. 2020 Jun;161(6):1227-1236. doi: 10.1097/j.pain.0000000000001826. PMID: 32168005; PMCID: PMC7230023.