Dysmenorrhea

Introduction to Dysmenorrhea Dysmenorrhea refers to the occurrence of abdominal pain in the lower abdomen before and after menstruation or during menstruation, and has general malaise, which seriously affects daily life. Both primary and secondary. After detailed gynecological clinical examination failed to find abnormal pelvic organs, said primary dysmenorrhea, also known as functional dysmenorrhea. Secondary dysmenorrhea refers to those with obvious lesions in the reproductive organs, such as endometriosis, pelvic inflammatory disease, and tumors. basic knowledge The proportion of illness: 0.03% Susceptible people: female Mode of infection: non-infectious Complications: infertility

Dysmenorrhea

There are many factors that cause dysmenorrhea. The following are common: (1) Cervical stenosis is mainly caused by obstruction of menstrual flow, causing dysmenorrhea. (2) uterine dysplasia uterine poor development is easy to merge with abnormal blood supply, causing uterine ischemia, hypoxia and causing dysmenorrhea. (3) Abnormal uterus position If the uterus position of the woman is extremely flexed or flexed, it may affect the menstrual bleeding and cause dysmenorrhea. (4) Mental, neurological factors Some women are overly sensitive to pain. (5) Genetic factors The occurrence of dysmenorrhea in the daughter has a certain relationship with the mother's dysmenorrhea. (6) Endocrine factors Menstrual period abdominal pain is associated with elevated progesterone in the luteal phase.

Other causes:

(1) Prostaglandin (PG) content in endometrium and menstrual blood increased, prostaglandin E2 (PGE2) has effect on uterine muscle fibers to cause contraction of dysmenorrhea, and the prostaglandin content in patients with endometrial tissue is significantly elevated. high.

(2) excessive contraction of the uterus, although the uterine contraction pressure of dysmenorrhea patients is basically the same as that of normal women (normal pressure is about 4.9Kpa), but the uterine contraction lasts for a long time, and often it is not easy to completely relax, so the excessive contraction of the factor palace occurs. Caused by dysmenorrhea.

(3) uterine abnormal contraction, dysmenorrhea patients often have abnormal uterine contraction, which often leads to uterine smooth muscle ischemia, uterine muscle ischemia can cause spasmodic contraction of uterine muscle, resulting in pain and dysmenorrhea.

(4) gynecological diseases such as endometriosis, pelvic inflammatory disease, adenomyosis, uterine fibroids, etc., placed in the uterus IUD (commonly known as birth control ring) can also cause dysmenorrhea.

(5) The first time of adolescent girls, psychological pressure, sedentary lead to poor blood circulation, poor blood circulation, love to eat cold food and other causes of dysmenorrhea.

(6) Strenuous exercise during menstruation, cold, cold and cold, etc., are easy to cause dysmenorrhea.

(7) The air is not well irritated by certain industrial or chemical odors, such as gasoline, fragrant water, etc., causing dysmenorrhea.

Dysmenorrhea prevention

Prevention: Women suffer from dysmenorrhea due to the special physiological phenomena of menstruation, belt, fetus and production, which are easy to cause disease and evil. Therefore, paying attention to personal health care is an effective measure to prevent dysmenorrhea.

(1) Learning to master menstrual health knowledge: The arrival of menstruation is a sign that women enter adolescence. However, some young women lack psychological understanding of menstrual bleeding, which will cause unnecessary fear, nervousness and shyness. Excessive and persistent stimulation of these unhealthy psychological changes can easily lead to air-conditioning disorders, poor blood flow and induce dysmenorrhea. Therefore, young women learn more about physiological health knowledge, remove misunderstandings about menstruation, and eliminate or improve bad psychological changes, which is the primary problem in preventing dysmenorrhea. As stated in "Su Wen, The Ancient Innocent Theory": "The gloom is nothing, the instinct is from it, the spirit is kept, and the illness is always."

(2) There must be a certain pattern in daily life: "Su Wen, Ancient Innocent Theory" said: "The person who knows it, the law is yin and yang, and the number of surgery, diet, and daily life, do not work, so can The shape and the gods, and the end of the year, the hundred years to go." That is to maintain physical health, we must abide by certain laws, adapt to changes in the natural environment, diet, daily life, work and rest, etc. Scientific arrangements will not cause illness. Due to special physiological phenomena, women must make reasonable arrangements in life, living and work, and have certain rules. It is not advisable to eat too cold, not to live in a cold and damp place for a long time, and should not be overworked or overworked, especially during the menstrual period, it is necessary to avoid cold stimulation, rain and wading, strenuous exercise and excessive mental stimulation.

(3) Actively carry out the five-stage health care: The fifth-stage health care refers to the health care of women during menstruation, pregnancy, puerperium, lactation, and menopause. In these five periods, women's ability to resist disease and evil is reduced, and it is easy to cause disease and evil. Seriously doing the five-stage health care is of great significance for the prevention of dysmenorrhea, especially for some patients with secondary dysmenorrhea, which is often caused by the unfavorable five-stage health care. In these five periods, whether it is personal hygiene, eating and drinking, emotional rehabilitation, labor training, etc., we must abide by certain protective measures so as not to cause women's illness, thus ensuring good health.

(4) Exercise to improve health: regular exercise, can enhance physical fitness, reduce and prevent the occurrence of disease. For example, Hua Wei, a medical scientist in the Han Dynasty, has long recognized that physical exercise can promote blood circulation, fluent joints, and smooth air movements, which can prevent diseases, thus creating the five birds play for the fitness of the world. Women often participate in some physical exercise, which is also good for preventing and treating menstrual pain.

(5) Actively conducting diagnosis and treatment of gynecological diseases : Actively and correctly examining and treating gynecological diseases is an important measure to prevent dysmenorrhea. First, the menstrual period should try to avoid unnecessary gynecological examinations and various operations. If the ring is released, the liquid is passed, and the gynecological examination should be performed within 3 to 7 days after the menstruation is cleaned, this will prevent the bacterial infection. Then, during the caesarean section and uterine incision, the muscle layer is sutured, and the suture should not pass through the endometrium to avoid endometriosis. The key is to find gynecological diseases, to do active treatment, in order to eliminate the hidden dangers of dysmenorrhea.

In short, the prevention of dysmenorrhea, from the menarche before the beginning of the active, until menopause can avoid the occurrence of dysmenorrhea. Especially for middle-aged women, don't mistakenly think that you don't have dysmenorrhea and relax your vigilance. This stage is mostly a high incidence stage of secondary dysmenorrhea. You must pay attention to personal hygiene and take corrective measures correctly. If you have dysmenorrhea, you should be active. Check and treat to ensure your health.

Dysmenorrhea complications Complications infertility

Primary dysmenorrhea generally has no complications; some secondary dysmenorrhea, not treated as early as possible, can cause serious complications such as infertility.

Symptoms of dysmenorrhea Common symptoms Abdominal pain, lower abdomen, pain, backache, lower abdominal pain, dizziness, breast pain, fatigue, nausea, stagnation, blood stasis, fever

First, the symptoms:

Dysmenorrhea is a common and frequently-occurring disease in gynecology. It has many causes, complicated pathogenesis, repeated and large treatments, especially for unmarried young women and early menstrual girls. It is mostly caused by menstruation or menstruation during menstruation or menstruation. A few hours before vaginal bleeding, periodic abdominal pain, cold pain, burning pain, tingling, dull pain, falling pain, cramping, cramping pain, tearing pain, pain extending to the back and even thighs And the foot, lasted 1/2 to 2 hours. Most of the pain is in the lower abdomen, and the severe one can be radiated to the lumbosacral or the anterior side of the femur. About 50% of patients have systemic symptoms: breast pain, anal bulge, chest tightness, irritability, irritability, apnea, headache, dizziness, nausea, vomiting, stomach diarrhea, fatigue, fatigue, pale face, cold limbs, cold sweat , vaginal discharge and other symptoms. After the onset of severe abdominal pain, it turned into moderate paroxysmal pain for about 12 to 24 hours. After the blood flow is unblocked, it gradually disappears, and occasionally it takes 2 to 3 days to stay in bed.

Second, the diagnostic criteria:

1, Chinese medicine dysmenorrhea syndrome is divided into five types of syndrome: qi stagnation and blood stasis, cold and dampness, dampness and heat resistance, qi and blood weakness, liver and kidney loss.

2, Western medicine dysmenorrhea diagnosis is divided into "primary" and "secondary":

(1) Primary dysmenorrhea

Refers to gynecological examination, genital organs without obvious organic lesions, more than 2-3 years after menarche, adolescent girls or young women who have given birth.

It often occurs in menstruation with ovulation, so it is usually asymptomatic or only mildly uncomfortable in the first 1-2 years after menarche. Severe spastic pain occurs mostly in young women 1 to 2 years after menarche. If regular dysmenorrhea occurs at the beginning or if dysmenorrhea occurs after the age of 25, other abnormalities should be considered. Primary pain often disappears after childbirth, or gradually disappears with age after marriage.

Diagnosis of primary dysmenorrhea

Mainly to rule out the possibility of secondary dysmenorrhea. The medical history should be asked in detail, paying attention to the time, type and characteristics of the onset of pain. according to:

1 onset within 1 to 2 years after menarche;

2 in the presence of menstrual blood or a few hours before the onset of pain, the duration of pain does not exceed 48 to 72 hours;

3 The nature of pain is sputum or similar to childbirth; 4 gynecological double or negative diagnosis. A diagnosis of primary dysmenorrhea can be obtained.

(2) secondary dysmenorrhea

Genital organs with obvious organic lesions, gynecological examination, B-mode ultrasound imaging, laparoscopy and other technical examinations have pelvic inflammatory disease, uterine tumors, endometriosis caused by dysmenorrhea.

II degree cervical erosion: inflammation can spread through the lymphatic circulation to the pelvic cavity leading to pelvic connective tissue inflammation, now lumbosacral pain, pelvic pain and dysmenorrhea.

Chronic endometritis: dysmenorrhea occurs more often in unmarried women, but severe dysmenorrhea is rare, may be due to excessive thickening of the intima, hinder the normal degeneration and necrosis of the tissue, and stimulate the excessive contraction of the uterus.

Chronic cervicitis: Pain often occurs in the lower abdomen or lumbosacral region, and is aggravated during menstrual periods, bowel movements, or sexual life.

Pelvic inflammatory mass inflammatory mass pelvic inflammatory disease abdominal pain will also increase in the menstrual period, but not as obvious as dysmenorrhea caused by endometriosis.

Uterine dysplasia: a history of primary amenorrhea, dysmenorrhea, infertility, habitual abortion, fetal position in each pregnancy, or dystocia.

Endometriosis: There was no pain in the past menstrual cramps, and dysmenorrhea began to appear from a certain period of time. Can occur before menstruation, menstruation and after menstruation.

Adenomyosis: Women over the age of 30 have secondary and progressive dysmenorrhea as the main symptoms of this disease.

Endometrial polyps: menstrual disorders, such as menorrhagia, menstrual extension, inter-menstrual bleeding, dysmenorrhea.

Vaginal schistosomiasis: irregular vaginal bleeding, menorrhagia and dysmenorrhea, vaginal discharge increased significantly.

Uterine fibroids, ovarian tumors: tumor compression or dysmenorrhea caused by other uterine inflammation.

Third, according to the degree of dysmenorrhea can be divided into 3 degrees:

(1) Mild: menstrual period or before and after abdominal pain is obvious, accompanied by pain in the waist, but can work, no systemic symptoms, sometimes need to take painkillers.

(2) Moderate: The menstrual period or before and after the abdominal pain is unbearable, accompanied by soreness in the lower back, nausea and vomiting, limbs are not warm, and pain is suspended with pain relief measures.

(3) Severe: the menstrual period or before and after the abdominal pain is unbearable, restless, seriously affecting work and study, daily life, must rest in bed, with sore waist, pale, cold sweating, cold limbs, vomiting diarrhea, or anus The bulge was relieved by the use of analgesic measures.

Dysmenorrhea

Repeated history of pelvic inflammatory disease, irregular menstrual cycle, menorrhagia, placement of intrauterine devices, infertility and other medical history contribute to the diagnosis of secondary dysmenorrhea.

Through double diagnosis and triple diagnosis, some causes of dysmenorrhea, such as uterine malformation, uterine fibroids, ovarian tumors, pelvic inflammatory disease, etc., can be found in the anus examination for uterine fibular ligament nodular thickening, for early diagnosis of uterus Endometriosis is particularly important.

Other tests: such as ESR, leucorrhea culture, B-ultrasound scan, hysterosalpingography, diagnosis of curettage, and finally the application of hysteroscopy, laparoscopic examination can clearly identify the cause of dysmenorrhea, hysteroscopy can be found in the small size of the curettage Lesions, such as small fibroids, polyps, ulcers, etc., provide a valuable diagnostic basis that can be performed after the diagnosis.

Dysmenorrhea diagnosis

If the medical history is not typical and the pelvic examination is not satisfactory, it should be used for B-ultrasound scanning. There is no positive sign in pelvic examination, contraceptive drugs or PGs synthesis inhibitors are used, and those with curative effect can diagnose primary dysmenorrhea. If the drug is ineffective for 5 to 6 cycles, laparoscopic or hysteroscopy should be further performed to exclude endoplasmic dysplasia and submucosal fibroids.

The diseases suggested by dysmenorrhea can be roughly divided into the following categories:

1. Menstrual low back pain may be caused by posterior uterus or other diseases.

2. Menstrual fever, lower abdomen pain may be suffering from pelvic inflammatory disease.

3. Normal menstrual blood is dark red. If the color of the menstrual blood is pale brown, or the smell changes and the temperature rises and the lower abdomen hurts, it may have endometritis.

4. If dysmenorrhea becomes more and more severe and lasts longer, it may develop endometriosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.