Abdominal pain before and after menstruation

Introduction Before and after menstruation, abdominal pain refers to the pain of dysmenorrhea before menstruation. It is one of the symptoms of dysmenorrhea. Dysmenorrhea refers to women with pain in the lower abdomen or waist, and even pain and lumbosacral. Every time with the menstrual cycle, severe cases can be accompanied by nausea and vomiting, cold sweats, cold hands and feet, and even fainting, affecting work and life. At present, it is often divided into primary and secondary in clinical practice. Primary dysmenorrhea refers to those with no obvious lesions in the reproductive organs, so it is also called functional dysmenorrhea. It is more common in adolescent girls, unmarried and married. This type of dysmenorrhea can relieve or disappear after normal childbirth. Secondary dysmenorrhea is caused by organic lesions in the reproductive organs. The disease is a common disease in gynecological clinics. According to relevant investigations, the incidence of dysmenorrhea is 33.19%.

Cause

There are many factors in abdominal pain, such as:

(1) Cervical stenosis, mainly due to obstruction of menstrual outflow, causing dysmenorrhea.

(2) uterine dysplasia, poor uterine development is easy to merge with abnormal blood supply, causing uterine ischemia, hypoxia and dysmenorrhea.

(3) Abnormal uterus position, if the woman's uterus position is extremely bent or flexed, it may affect the menstrual bleeding and cause dysmenorrhea.

(4) Mental and neurological factors, some women are overly sensitive to pain.

(5) genetic factors, daughters have a certain relationship between dysmenorrhea and maternal dysmenorrhea.

(6) Endocrine factors, abdominal pain during menstruation is associated with elevated progesterone in the luteal phase.

(7) gynecological diseases, such as endometriosis, pelvic inflammatory disease, adenomyosis, uterine fibroids. It is currently believed that increased prostaglandin levels in the endometrium and blood are the main causes of dysmenorrhea. Because a large number of prostaglandins have an excitatory effect on the uterus, it can cause strong contraction of the uterine muscles, uterine ischemia, hypoxia and more severe pain, so there is dysmenorrhea.

an examination

Related inspection

Gynecological routine examination of gynecological health examination gynecological ultrasound examination

Before and after menstruation, abdominal pain is manifested as women's menstrual period or before and after menstruation, periodic abdominal pain, cold pain, burning pain, tingling, dull pain, falling pain, colic, spastic pain, tearing pain, pain extended to Waist back, even involving the thighs and feet, often accompanied by systemic symptoms: breast pain, anal bulge, chest tightness, irritability, irritability, apnea, headache, dizziness, nausea and vomiting, stomach pain, diarrhea, fatigue, pale, Cold limbs, cold sweats, vaginal discharge and other symptoms.

Differential 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.

What are the symptoms of abdominal pain before and after menstruation?

First, primary dysmenorrhea: primary pain often occurs in ovulation menstruation and therefore no symptoms or only mild discomfort after 1 to 2 years after menarche. Severe spastic pain occurs mostly in young women after 1 to 2 years of menarche. If there is regular dysmenorrhea at the beginning or if dysmenorrhea occurs after the age of 25, other abnormalities should be considered. Most of the dysmenorrhea begins with menstrual cramps or convulsions for several hours before vaginal bleeding, which lasts for 1/2-2 h. After the onset of severe abdominal pain, it turned into moderate paroxysmal pain for about 12-24 hours. After passing through the blood flow, it gradually disappears and occasionally needs to stay in bed for 2-3 days. The pain is in the lower abdomen, and severe cases can be radiated to the lumbar energy or about 50% of the anterior side of the femur with gastrointestinal and cardiovascular symptoms. Such as nausea, diarrhea, dizziness, headache and fatigue. Occasionally, syncope or collapse of gynecological double or negative anal diagnosis, can be diagnosed with primary dysmenorrhea.

Second, secondary dysmenorrhea: According to the gynecological examination of the medical history and the necessary auxiliary diagnostic methods to determine what gynecological diseases are caused by dysmenorrhea.

(a) pelvic endometriosis: dysmenorrhea is the main symptom of endometriosis ovary, uterine fibular ligament, uterine rectal pelvic peritoneal ectopic endometrial tissue is also affected by ovarian hormones in the menstrual cycle There are periodic changes in the impact.

(B) adenomyosis: a benign lesion caused by endometrial invasion of the myometrium is one of the typical symptoms of this disease. There may also be an increase in menstrual flow or a prolonged menstrual period. Gynecological examination of the uterus is uniform and spherical, the texture is hard, generally about 2 months of pregnancy can be mild tenderness.

(C) uterine fibroids: dysmenorrhea is not the main symptom of uterine fibroids but submucosal fibroids in the menstrual period can cause spasm pain due to stimulation of uterine contractions. Patients with more menorrhagia, prolonged menstruation or irregular vaginal bleeding pelvic examination can be found that the uterus is increased to varying degrees, the surface is smooth or nodular.

(D) chronic pelvic inflammatory disease: lower abdominal pain and infertility is the main symptom of chronic pelvic inflammatory disease in the menstrual period due to pelvic congestion or acute inflammation caused by menstruation, can cause abdominal pain. Patients with infertility and acute pelvic inflammatory disease, pelvic examination of the uterus mostly in the posterior position, poor mobility, or even completely fixed

(5) genital malformations: In the embryonic development, one side of the middle kidney tube can develop well, forming a well-developed single-horned uterus. The other side of the renal tube does not develop well to form a residual angle or primordial uterus, and the contralateral side does not penetrate, nor does it lead to the primordial uterus in general without uterine cavity, or the uterine cavity also lacks the endometrium; The uterus has a functional response, which is characterized by periodic bleeding that can cause dysmenorrhea due to uterine hemorrhage. Most of the patients are girls.

(6) Intrauterine device: dysmenorrhea can also be seen in women in the intrauterine placement of the device. This type of dysmenorrhea may be caused by an increase in prostaglandins produced by the endometrium, or it may be the rejection of the uterus muscle by the IUD. Patients with spastic pain in the lower abdomen often have lower abdomen or lumbosacral discomfort. The symptoms of menstrual period are aggravated. It is manifested that the placement of the dysmenorrhea device is improper or too large, which may cause uterine contraction, resulting in lower abdominal pain and dysmenorrhea.

(7) Pelvic venous congestion syndrome: This disease is caused by chronic pelvic venous congestion. The clinical manifestations of female genital diseases mainly include pelvic bulge, lower abdomen and lumbar energy, and often accompanied by increased leucorrhea during menstruation. Dysmenorrhea. When tired, sedentary, sedentary, or constipation, the symptoms often aggravate some patients with breast pain and bladder and rectal irritation. It is characterized by cyclical abdominal pain, cold pain, burning pain, tingling, dull pain, falling pain, cramping, cramping pain, tearing pain, pain extending to the back of the back and even after menstruation or menstruation. Thighs and feet, often accompanied by systemic symptoms: breast pain, anal bulge, chest tightness, irritability, irritability, apnea, headache, dizziness, nausea, vomiting, stomach pain, diarrhea, fatigue, pale, pale limbs, cold sweats , vaginal discharge and other symptoms.

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