Painful periods

Dysmenorrhea is one of the most common gynecological symptoms. It refers to those who have lower abdominal pain, swelling, backache or another discomfort before and after menstruation or during menstruation, and the symptoms seriously affect the quality of life.

Dysmenorrhea is divided into primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to dysmenorrhea without organic diseases in the reproductive organs; secondary dysmenorrhea refers to pelvic organic diseases, such as endometriosis, uterus Dysmenorrhea caused by adenomyosis.

Cause

1. The occurrence of primary dysmenorrhea is mainly related to the increased prostaglandin content in the endometrium during menstruation. The main cause of dysmenorrhea when the content of PGF2α increases. The high content of PGF2α can cause excessive contraction of uterine smooth muscle, vasospasm, and cause dysmenorrhea due to uterine ischemia and hypoxia.

2. Increase of vasopressin, endogenous oxytocin and β-endorphin and other substances.

3. Mental and neurological factors.

4. Secondary pain is often caused by endometriosis and adenomyosis.

Clinical manifestations

1. Primary dysmenorrhea is more common in adolescence, often onset within 1 to 2 years after menarche. Pain in the lower abdomen is the main symptom that accompanies menstrual cycles regularly. The symptoms of secondary dysmenorrhea are the same as those of primary dysmenorrhea, and secondary pain caused by endometriosis is often progressively worse.

2. The pain usually starts after menstrual cramps, and the earliest appears 12 hours before menstruation. The pain is the most severe on the first day of menstruation, and it is relieved after 2 to 3 days. The pain is often spastic. Generally not accompanied by abdominal muscle tension or rebound pain.

3. It may be accompanied by symptoms such as nausea, vomiting, diarrhea, dizziness, fatigue, etc. In severe cases, the complexion becomes pale and cold sweats occur.

4. No abnormal findings in the gynecological examination.

Diagnosis

According to the lower abdominal pain during menstruation, the gynecological examination has no positive signs, and it can be diagnosed clinically.

Differential diagnosis

It needs to be differentiated from secondary dysmenorrhea caused by endometriosis, adenomyosis, and pelvic inflammatory disease.

1. Endometriosis

(1) Symptoms: dysmenorrhea, infertility.

(2) Gynecological examination and auxiliary examination: Endometriotic lesions were found in the pelvic examination; Endometriotic lesions were found in imaging examination (pelvic ultrasound, pelvic CT and MRI), and serum CA125 levels were slight to moderately elevated.

(3) Laparoscopy: Laparoscopy is the current general method for diagnosing endometriosis. The diagnosis can be confirmed by seeing the typical lesions described in gross pathology under laparoscopy or by biopsy of suspicious lesions.

2. Adenomyosis

①Symptoms: dysmenorrhea; abnormal menstruation (can be manifested as menorrhagia, prolonged menstruation and irregular bleeding);

②Gynecological and auxiliary examinations: uterine enlargement, tenderness, etc.; imaging examination (pelvic ultrasound), serum CA125 and other prompts.

Treatment

Dysmenorrhea is a common symptom in women. Dysmenorrhea will disappear naturally after unmarried dysmenorrhea after being older, especially after marriage and childbirth, and treatment is not necessary. Except in individual cases. However, if the pain of dysmenorrhea lasts as long as 3 days, those who affect their lives should be treated. The treatment of primary dysmenorrhea is mainly symptomatic, mainly with analgesia and sedation.

1. General treatment

(1) Attach importance to psychotherapy to eliminate tension and worries.

(2) Adequate rest and sleep, regular and moderate exercise, and quit smoking.

(3) When the pain is unbearable, supplement with medication.

2. Medication

Reference:

Sun Haiyan, Cao Yongxiao, Liu Jing, etc. Establishment of a mouse model of dysmenorrhea. "CNKI", 2002

Ji Bo, Ren Xiaoxuan, Zhao Yafang, etc. A review of research on the pathogenesis and prevention of primary dysmenorrhea. "VIP", 2008

Peng Chao, Zhou Yingfang, Liao Qinping. A study on the correlation between the intensity of dysmenorrhea and prostaglandins in patients with adenomyosis. 2006

Cao Yunxia. The pathogenesis and prevention of primary dysmenorrhea. "Chinese Journal of Practical Gynecology and Obstetrics", 2001

Wang Ping, Zhang Lanzhu. Sixty-six cases of primary dysmenorrhea treated with Siwu Decoction and Shixiao Powder. "Modern Journal of Integrated Traditional Chinese and Western Medicine", 2004

经痛 經痛

痛经为最常见的妇科症状之一，指行经前后或月经期出现下腹部疼痛、坠胀，伴有腰酸或其他不适，症状严重影响生活质量者。