Most representatives of the fair sex sooner or later have to deal with various diseases of the sexual sphere. So, it can be amenorrhea, dysmenorrhea, uterine fibroids, hormonal abnormalities, causing pathological processes, and so on. Those women who do not know about one of these ailments throughout their lives are very lucky. This article will discuss what kind of treatment involves dysmenorrhea (what it is, it will also be discussed). You will learn about the causes of pathology and its symptoms.
Dysmenorrhea: what is it?
Specialists often equate this pathology with a pronounced premenstrual syndrome. However, such a physiological process is recognized as an independent disease. If you are diagnosed with "dysmenorrhea", what it is, the specialist will tell. Those women who have never encountered such a pathology should learn that dysmenorrhea is called menstruation disorder.
Dysmenorrhea - what is it? And is the disease dangerous? As a rule, yes. However, it is worth considering each case individually. If the pathology of one woman can face serious consequences, then other representatives of the fair sex do not cause any problems other than physical discomfort.
Dysmenorrhea is a very insidious disease. She may not give any symptoms throughout the entire menstrual cycle, but with the onset of menstrual pathology simply knocks a woman out of a rut. Most of the fair sex, suffering from this pathology, become disabled during the exacerbation of the disease. Women are forced to miss work and school for several days. Pathology does not allow to live normally and even sleep.
It is worth noting that women during menopause and menopause do not suffer from such ailment. The disease affects only those representatives of the fair sex who are in reproductive age. Also, the disease is bypassed by girls who already have menarche, but still do not have ovulation.
How does the disease manifest?
Dysmenorrhea symptoms have the following:
- lower abdominal pain a few hours before and during menstruation,
- nausea or vomiting that does not bring relief,
- upset stool (most often a dilution of feces or diarrhea),
- headaches and nervous tension
- decreased performance due to weakness
- increase in body temperature to 38 degrees.
It is worth noting that every woman can manifest ailment differently. So, some women complain of unbearable cramping pain, while others say that they are tormented by vomiting and fever.
Dysmenorrhea: causes of the disease
Depending on what type of pathology the woman had to face, the causes of the disease can be identified different. For a start it is worth saying that dysmenorrhea has two forms. It is in connection with them that the causes of the disease are divided into natural and pathological.
Primary form: causes
Young women who have not given birth have a form of a disease called primary dysmenorrhea. In this case, the disease is susceptible to representatives of the weaker sex, in whom hormonal adjustment has begun, and the menstrual cycle has recently been established.
Primary dysmenorrhea in this case has hormonal causes. Due to improper hormone production, estrogen prevails over progesterone. The uterus in this case has an elastic structure. Overflowing with blood during menstruation, the reproductive organ begins to shrink strongly. All this causes severe cramping in the lower abdomen, indigestion and general deterioration of health.
Also, the cause of this type of pathology can be an abnormal thyroid gland. In this case, hormone production is also impaired. Most often increases the release of prostaglandins. They affect the genital organ, increasing its contractile activity during menstruation.
Secondary form: causes
Women who give birth or women who are more than 30 years old have a pathology called secondary dysmenorrhea. However, medicine knows cases where the disease was detected in young girls.
The cause of the disease in this case are acquired during the life of the disease. These include endometriosis, adenomyosis, endometritis, inflammation and sexually transmitted diseases.
If the secondary form is accompanied by endometriosis, the cause of the disease is improper production of estrogen. At the same time, the endometrium grows in the peritoneum, and its normal functioning begins. In this case, the release of blood into the abdominal space causes unbearable pain, fever and deterioration of health.
In inflammatory or infectious diseases, dysmenorrhea is physiological. In this case, the body begins to release a protective fluid, which quickly leads to the formation of adhesions.
Depending on what form of the disease is detected in a woman, the methods of adjustment may be different. It is worth noting that treatment can be conservative, popular, surgical or manual. Consider how patients with dysmenorrhea receive treatment. Drugs are also worth mentioning.
Primary form: correction
Since most women with a similar pathology are in the reproductive age, but do not yet plan to give birth to children, doctors recommend the use of hormonal drugs that suppress ovulation. Such means restore the cycle and reduce the volume of menstrual blood. By hormonal drugs of this action include the following: "Janine", "Novinet", "Logest", "Diane-35" and others.
Pathology treatment can be done by suppressing the high estrogen production. To do this, prescribed drugs that need to be taken from the middle of the cycle. These include the following drugs: Duphaston, Utrozhestan, Progesterone, and other medicines.
Also, primary dysmenorrhea treatment may suggest symptomatic. In this case, women are prescribed remedies for suppressing pain. The drugs are prescribed the following: "No-Shpa", "Papaverin", "Drotaverin", "Spazmalgon" and others.
Almost all women suffering from primary dysmenorrhea are prescribed sedatives. Such drugs include "Valeriana", "Motherwort", "Novopassit" and other drugs.
In addition to medication, treatment requires bed rest. The patient is recommended to rest more and have a full sleep. Also, doctors prescribe compresses in the form of attachment of warm objects to the lower abdomen. When the temperature rises, one should take Paracetamol tablets or Ibuprofen medicine. If there is vomiting or diarrhea, then a certain diet is prescribed.
Secondary form: correction
In this case, the treatment of pathology has almost the same scheme as in the primary form of the disease. However, some more drugs are added, without which the correction will simply be ineffective.
If dysmenorrhea is accompanied by endometriosis, the treatment requires a serious hormonal correction. In this case, drugs such as Zoladex and others are used. Also, the treatment can be carried out by surgery. Laparoscopy is most commonly used.
In the case where the pathology is caused by an inflammatory process, means are used to eliminate it. So, tablets "Vilprofen", medicine "Doxycycline", candles "Terzhinan" and others are often prescribed.
In addition to all of these, the doctor recommends the use of tools that reduce the likelihood of adhesions. These include the drug "Longidase" (or "Lidaza"). Also, physicians prescribe physiotherapy, which is aimed at eliminating the resulting films between the pelvic organs.
Consequences of the disease
So, you now know what dysmenorrhea is in women. The consequences of pathology can be completely unexpected. If the primary form most often passes without a trace, then secondary dysmenorrhea can be very dangerous. In the absence of timely treatment aimed at eliminating the causes of pathology, a woman may be infertile in the future. In the presence of endometriosis begins the defeat of new organs. If the pathology is caused by inflammation or infection, an adhesion process is formed that can lead to ectopic pregnancy. This complication can be life-threatening for a woman.
To avoid the occurrence of consequences, it is necessary to promptly correct the disease. Never self-medicate. Refer to experienced doctors who, after diagnosis, prescribe the appropriate drugs.
Pain during menstruation is considered one of the most common. Almost 90 percent of all women in the world experience painful sensations in one degree or another with or directly from the vaginal discharge. However, this is not considered a pathology. Another danger is that the pain syndrome can be so pronounced that it will lead to a temporary loss of the patient's ability to work.
This condition is called dysmenorrhea. It has the highest prevalence among young girls, and it is less and less common with age. This is due to the fact that age-related pains are much more often associated specifically with various diseases of the reproductive organs.
The severity of the problem depends on the surrounding factors. Women are at risk for dysmenorrhea if they:
- malnourished, not getting enough healthy micronutrients and minerals with food,
- subject the body to significant physical exertion
- suffer from constant exposure to negative environmental factors, such as low temperatures,
- underwent surgery on the genitals
- prone to depression and stress
- have various infectious diseases of the genitourinary system,
- suffered injuries and other mechanical damage to the pelvis.
Medicine knows that dysmenoria can be inherited.
Almost 40 percent of women whose mothers suffered from this pathology are also susceptible to its development. There is also a psychological factor - representatives of the beautiful half of humanity, who from time to time are immersed in severe depressions, more often suffer from painful menstruation.
Contrary to popular belief, to distinguish dysmenoria, as a pathological condition, from the usual pain during menstruation, is quite simple. In the second case, the uterine muscle tissue is actively reduced, thus getting rid of menstrual products. Because of this, the woman has a feeling of pulling pain in the lower abdomen. However, such pains are not characterized by constancy, moreover, their intensity is relatively weak, which means that they in no way affect the ability of a person to work and the likelihood of leading a normal, fulfilling life.
Symptoms of the disease
What is dysmenorrhea? This is not just severe pelvic pain. This disease is also characterized by other symptoms, which in some cases can be expressed very strongly. In general, the symptoms of pathology are as follows:
- slight nagging pains on the eve of the beginning of menstruation and on the first day of discharge. There are no vegetative disorders, which is very important, since the patient’s ability to work remains. Such symptoms suggest that a woman has an initial stage of dysmenoria. She is simply treated, but only if she is given proper attention. In the absence of proper treatment, the situation can be significantly aggravated,
- moderate systemic pain that lasts for several days after the onset of menstruation. Here, symptoms are much more pronounced - these are nervous disorders, functional disorders of the gastrointestinal tract, headaches, nausea and vomiting, convulsions, loss of consciousness, insomnia, etc. To lead a relatively normal life, the patient will need to regularly take appropriate medications,
- heavy menstrual pains, which are accompanied by a whole set of various disorders and problems. Last for almost the entire period of menstruation, characterized by their agony, exhausting the already weakened body of a woman. It should be noted that practically any working capacity of the patient is completely lost, and even strong painkillers cannot correct the situation.
If you feel the symptoms of dysmenorrhea, for example, that menstrual pains suddenly become more intense, and also appear regularly, you should immediately visit a specialist.
To date, there are two forms of this pathology - the primary, which is also called spastic, and secondary. In the second case, we are talking about various comorbidities, and not only the organs of the reproductive system, but also other equally important parts of the female body. Primary is provoked by the following factors:
- physiological features of the patient,
- the psychological reason is that a woman at the subconscious level expects significant painful sensations from her monthly
- hormonal disruptions.
The first characteristic symptoms of this pathological condition appear as early as one or two years after the start of the menstrual cycle. Naturally, the initially occurring pain is not too intense, and therefore easily eliminated with the help of conventional painkillers. There is no significant discomfort in the girl’s everyday life. However, the lack of due attention to this problem on the part of parents can eventually lead to the fact that the pathology is significantly aggravated, and to adulthood will become much more pronounced.
What is primary dysmenorrhea? Contrary to popular belief, painful menstruation at an early age is not associated with structural changes in the genital organs, that is, various diseases. In this case, the culprits are biologically active substances. Increased production of a certain hormone - for example, estrogen, progesterone or even male testosterone, causes excessive arousal of the body, and one of the manifestations of this condition is too frequent and strong contraction of the uterus muscles - the main cause of pain.
In women of more mature age (up to 30 years), spastic dysmenoria can have not only hormonal or psychological origin, but also physiological. As a rule, provoking pathologies are associated with the uterus. For example, it may have a curved cervix, or its excessively narrow channel. All this may be due to both congenital features, and the consequences of past diseases.
Due to physiological problems with the uterus, the passage of secretions through it can be significantly difficult. As a result, the tissues of the uterus are experiencing strong tension, and the woman feels it as pain.
Severe menstrual pains that have caused a lot of torment to a girl will almost always instill fear in her with the probability of her repetition. Accordingly, the psyche can artificially intensify the usual pain syndrome, characteristic of almost any period, taking them for this severe pathology.
Drugs for the treatment of dysmenorrhea
Today, the treatment of this pathology is carried out using three main groups of pharmacological drugs:
- Progestin Designed to normalize hormonal levels. This group includes medicines developed on the basis of natural biologically active substances or their synthetic analogues. Their effect is that they increase the level of the missing hormone, thereby stabilizing the patient's condition. Against the background of the normalization of hormonal background, a significant decrease in the frequency of uterine muscle contraction is observed, as a result of which the pain syndrome is also eliminated. Also, these drugs serve to normalize the menstrual cycle, which becomes more predictable.
- Hormonal contraceptives. Such means include contraceptives containing estrogen - both real and synthetic. They may be injectable or oral. Their use is important if the patient seeks to have a full sex life. The essence of their actions is similar to the above drugs.Regular use of hormonal contraceptives will significantly reduce the risk of uterine bleeding, ectopic pregnancy, the appearance of benign and malignant tumors. Also, these tools contribute to the effective elimination of cosmetic problems, such as acne, which very often appear during menstruation.
- Anti-inflammatory. Drugs that have anti-inflammatory effects, and which are nonsteroidal, are excellent for significantly reducing the severity of pain. Their action lasts, on average, from four to six hours, depending on the intensity of the pain syndrome.
Such remedies are excellent for patients who are contraindicated in hormone therapy or who do not want to use them for personal reasons.
All the above methods of treatment relate exclusively to primary dysmenorrhea. The secondary will require the initial elimination of the provoking factor, that is, the underlying disease.
What is dysmenorrhea and how to treat this pathology, the attending physician will tell you in detail. It must be remembered that to endure such a state, using a huge amount of painkillers and other means, is absolutely not recommended. Only a professional who is well versed in the features of painful menstruation can help here.
What caused the reasons?
The causes of the disease are often associated with a hereditary factor, the constitutional features of the female body. The primary cycle disorder is usually detected with the arrival of ovulation, preceded by:
- inflammatory process occurring in the pelvic organs,
- constant stressful conditions of a woman, fear of painful periods,
- hormonal disorders in connection with the installation of the intrauterine device,
- leading a promiscuous sex life with different partners,
- development of endometriosis, germination of the endometrial epithelium inside the uterus,
- similar feminine ailments that occurred at relatives in a straight line (moms, grandmothers),
- drinking coffee in large quantities.
How to recognize the disease?
For the first time, the symptoms of dysmenorrhea usually begin to manifest in girls with the arrival of menarche and then for 2 years, menstruation is irregular until the ovulatory cycle is completely regulated. In girls, pain occurs immediately with the arrival of menstruation or shortly before them.
Manifestation of premenstrual syndrome, often against the background of other related pathologies: flatfoot, scoliosis, mitral valve prolapse, dystonia vegetovascular, myopia. Pathology has a vegetative or psycho-emotional nature. At a younger age, girls suffer from migraine, increased sweating, cardiac pain in the heart, bladder and bowel dysfunction. With the arrival of menstruation, some girls, due to fluid retention in the tissues of the uterus, begin to gain weight quickly, their face and limbs swell. In severe course of the primary illness faints are possible.
If girls are psychopaths, have asthenic physique, then with the arrival of menstruation aggression, anxiety, irritability, loss of sleep, apathy, loss of appetite increases. The integuments of the skin turn pale, and the vascular net is seen through the thin skin due to the thinning of the vessels. Due to lack of complexion, care in the shade against the background of these pathologies, a violation of posture, the development of kyphosis, scoliosis, and lordosis are possible.
The first and main symptom of primary dysmenorrhea is painful flow of menstruation, but there is no disease of the genital organs. Usually manifested after the first menstruation in girls.
They are disturbed by lower abdominal pain with backlash, nausea, vomiting approaches, sleep is disturbed, anxiety is present, intestinal disorders are possible. It dyspeptic and cerebral disorders suggest that menstruation pain is associated with changes in the level of prostaglandins, but when viewed from the pathological processes in the organs are not traced.
With a large release of hormones into the blood: adrenaline, norepinephrine, serotonin, dopamine, a woman is worried about:
- Temperature rise to subfebrile marks.
- Symptoms of arrhythmia (heart rate decreased).
- Pulling sharp pains
First, the gynecologist interviews the patient about how menstruation occurs. Then he feels his stomach, prescribes blood and urine tests. For laboratory study, the analysis of biochemistry will determine the hormonal balance (imbalance) of the patient. Conducting an ultrasound will identify the factors that caused the development of dysmenorrhea. According to the results of tests, it is prescribed by decision of a doctor, reoencephalography, hysteroscopy, laparoscopy.
How to treat dysmenorrhea?
Primary dysmenorrhea in adolescent girls leads among all other gynecological diseases. The frequency of cases up to 90%. The illness often develops on the background of the failure of the nervous, endocrine, and metabolic systems. Along with painful attacks there is diarrhea, vomiting, nausea, weakness.
If the degree of dysmenorrhea is mild, then the symptoms and pain are minor. The doctor does not prescribe medication. With primary dysmenorrhea, which did not lead to a violation of the monthly girls, it is enough to revise your lifestyle, diet, psycho-emotional state. It is advisable to take antioxidants, vitamin E.
Many girls with signs of dysmenorrhea are deficient in magnesium. Magnesium salts are prescribed, for example, B6 magnesium.
The course of therapy depends on the hormonal background of the patients. When dysfunction is not enough luteal phase in the body. Progesterone drugs are prescribed, with an excess of estradiol secretion - hormonal drugs. To reduce pain, the doctor will prescribe painkillers with nonsteroidal drugs: diclofenac, ibuprofen, nimesulide, no-spa, papaverine, drotaverin. Sedative drugs for primary dysmenorrhea: motherwort, Novo-Passit, Valerian. At a temperature: paracetamol, ibuprofen. When vomiting diarrhea - a special diet.
If dysmenorrhea is suspected, it is advisable to start taking drugs 2-3 days before the arrival of menstruation. So the relief of unpleasant symptoms will be more effective.
Symptoms of vomiting and nausea usually subside as the spasms subside. To alleviate the condition, antiemetics may be prescribed. To suppress ovulation with dysmenorrhea, knocking over from the usual rhythm of life, oral contraceptives are prescribed: estrogen, progestin. A woman is recommended to rest more these days, to exercise in a mild form.
Teenage girls with dysmenorrhea are recommended to take homeopathic medicines. If there is no effect, laparoscopy of the abdominal cavity is prescribed to clarify the cause that led to the illness. In the complex treatment is carried out with herbal medicine, electrophoresis, hypnosis, acupuncture. Possible surgical intervention to expand the uterine canal in case of excessive narrowing. What to expect later?
Primary dysmenorrhea is a pathology and the consequences are different. This form often goes away on its own with stabilization of hormonal levels and nutrition correction. But doctors are aware of cases of transition of the primary form to the secondary, in women who have given birth after 30 years.
Secondary dysmenorrhea is more dangerous with the development of endometriosis on the background of inflammation or infection. Endometrial layers are affected, adhesions are formed. Complications are dangerous for women's health, lead to ectopic pregnancies, and eventually to infertility. It is important to correct the ailments that have arisen in a timely manner so that further sad consequences do not lead by surprise. Self-treatment, a rough introduction to the hormonal fragile background of a woman is unacceptable. Prescribing treatment should be done only by a doctor.
Today, primary dysmenorrhea is diagnosed quickly. The doctor will establish a form of dysmenorrhea, timely treatment gives positive results. Girls with the arrival of menstruation or the onset of sexual activity should not forget about preventive measures. Regular visits to the gynecologist for examination, the installation of intrauterine devices before the birth of the first child, also abortions, any other mechanical effect on the uterine mucosa is undesirable. It leads to menstrual disorders, other serious inflammations, the treatment of which may take too long.
Dysmenorrhea: a modern classification of the pathological condition
Distinguish between primary and secondary dysmenorrhea.
In primary dysmenorrhea, there are no pathologies on the part of the female reproductive system, this condition is functional. Secondary dysmenorrhea occurs against the background of organic pathologies of the pelvic organs.
The most common symptom of dysmenorrhea is abdominal pain, which in many cases is accompanied by nausea and even vomiting. Rarely, but quite often, women complain of general weakness, back pain, dizziness, headache and diarrhea.
The clinical picture and the pathogenesis of the development of primary dysmenorrhea
In primary dysmenorrhea, pain usually occurs on the first day of menstruation, is localized in the lower abdomen, and may radiate to the lumbar region and thighs. It lasts about 24-48 hours, after which it disappears on its own. Primary dysmenorrhea is cyclical. The basis of the pathogenesis of this pathological condition is overproduction of prostaglandins of the mucous membrane of the uterus.
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These biologically active substances cause smooth muscle spasm, reduce blood flow and cause ischemic uterine pain. When it enters the bloodstream, prostaglandins also show a systemic effect, thereby causing a feeling of general weakness, nausea, vomiting, headache and other symptoms.
Treatment of primary dysmenorrhea: current approaches and recommendations
Treatment of primary dysmenorrhea includes counseling the patient about the nature of the occurrence of pain during menstruation, as well as the appointment of nonsteroidal anti-inflammatory drugs. The latter inhibit the action of cyclooxygenase and, as a result, reduce the synthesis of prostaglandins.
Combined oral contraceptive use It can also be effective in eliminating the symptoms of primary dysmenorrhea. Their regular intake helps to reduce the thickness of the endometrium and, consequently, reduce the production of prostaglandins.
In the treatment of primary dysmenorrhea, the use of combined oral contraceptives and analgesics can be combined.
It is worth making sure that the patient has no contraindications for prescribing combined hormonal contraceptives. An alternative to preformed hormonal drugs can be hormonal intrauterine systems. At the same time, the local action of hormones practically does not cause systemic effects in the female body.
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Causes of dysmenorrhea
Such a normal condition for an adult woman as menstruation can become not only an unpleasant medical problem, but also have social significance. The deterioration in the quality of life associated with dysmenorrhea leads to temporary disability in 80-85% of the female population, starting at school. Among adolescents pronounced pain syndrome during menstruation occurs in 40-75% of cases and grows every year. Almost every second woman at a young age has manifestations of dysmenorrhea, which gradually decrease with age or disappear completely after childbirth. In adulthood, menstrual pain is most often associated with acquired genital pathology.
The severity of the manifestations of the disease depends on the living and working conditions. Women who do not receive adequate nutrition and are engaged in heavy physical labor, including sportswomen, suffer from menstrual pain much more often than others. Adverse external factors can also lead to the development of a pathological process. Often, hypothermia, infectious diseases, injuries, stressful situations, surgery on the genitals contribute to the occurrence of the disease. Harmful habits, especially nicotine addiction, increase the risk of dysmenorrhea at a young age several times.
There is a genetic predisposition to the development of menstrual disorders, in about 30% of women with dysmenorrhea, the daughter suffers from the same disease. An important role in the occurrence of menstrual pain plays an emotional component. Girls and women prone to severe depression are more likely to suffer from dysmenorrhea and premenstrual syndrome.
Very often, menstrual bleeding completely changes the rhythm of everyday life. Sometimes “critical” days are so critical that they force a woman to spend several days in bed, suffering from pain. Depending on the intensity of the pain, there are three forms of the disease:
- Light menstrual pains disturb a woman only on the first day from the onset of menstruation, are not accompanied by autonomic disorders and do not lead to disruption of vital activity. This form of the disease is most common among the female population and, despite a fairly mild course, in the absence of proper attention to their health, it can worsen over time.
- Mild menstrual cramps are observed for several days from the onset of menstruation and are accompanied by systemic disorders (headaches, fainting, cramps, nausea, vomiting, diarrhea, frequent urination, bloating, nervousness, insomnia). The performance is significantly reduced and usually taking medication is required to maintain full activity.
- Severe menstrual pains develop from the beginning of menstruation and last up to 5-7 days, have a pronounced debilitating character, accompanied by a full range of systemic disorders. Efficiency is usually lost completely, even while taking painkillers.
In clinical practice, primary (spastic) and secondary (organic) dysmenorrhea, distinguished by a developmental mechanism, are distinguished. In primary dysmenorrhea, organic gynecological pathology is usually absent. The cause of pelvic pain in secondary dysmenorrhea is inflammatory or neoplastic diseases of the genital organs: endometriosis, ovarian cysts, chronic salpingitis, oophoritis, adnexitis, adenomyosis, polyposis, cervical stenosis, genital malformations, bacterial, viral and fungal infections. Also quite often provokes menstrual pain intrauterine contraception.
The most common causes of secondary dysmenorrhea are genital endometriosis and chronic inflammatory diseases of the reproductive organs (adnexitis, salpingoophoritis). The mechanism of pain in secondary dysmenorrhea is not much different from that in the primary. The main difference is the aggravation of the course of the disease under the action of morpho-functional disorders of the organs of the reproductive system.
In inflammatory diseases, inflammatory mediators are released, which additionally affect the nerve endings during the menstrual cycle. With the involvement of the surrounding organs in the pathological process, adhesions form, tissue fibrosis occurs, which causes soreness during their displacement and tension. During tumor processes and cystic changes, the surrounding tissues are compressed by growing growths. The formation of obstacles in the path of menstrual blood contributes to its accumulation in the uterus and a reverse flow occurs through the fallopian tubes with effusion into the abdominal cavity. Feeling of bursting, burning in the lower abdomen and in the external genital organs, increased pain when changing body position, irradiation to the lower back, kidneys, bladder, epigastrium can accompany the period of menstrual bleeding and even continue for several days after it. Monthly usually abundant, with a large number of clots, long. Pains are more often acyclic in nature and worried throughout the cycle, increasing during ovulation and with the onset of menstruation. In the rest of the time, constant pulling pains in the lower back and lower abdomen, accompanied by abnormal secretions from the genital tract, to a great extent exhaust the woman and help reduce the pain threshold. One of the manifestations of secondary dysmenorrhea can be dyspareunia (pain during intercourse), which adversely affects not only the physical but also the mental health of a woman.
In the case of chronic recurrent inflammation, the pain syndrome may increase many times in the premenstrual period and subside with the onset of menstruation. In addition to pain, the patient may be concerned about the increase in body temperature and the effects of intoxication associated with exacerbation of the inflammatory process.
У женщин в зрелом возрасте, страдающих дисменореей, сопутствующие симптомы зависят от ее физического состояния и чаще всего касаются сердечно-сосудистой и нервной систем. In addition, such women are more susceptible to depressive disorders and have a pronounced unstable psycho-emotional mood.
The treatment of painful menstruation is mainly pharmacological and is aimed at correcting hormonal disturbances. Pain in dysmenorrhea is effectively eliminated by the use of inhibitors of the synthesis of prostaglandins and oral contraceptives. Combined hormonal drugs create the necessary elevated levels of progesterone, which block the synthesis of prostaglandins during menstrual bleeding. The use of oral contraceptives has a positive effect on various violations of the menstrual-ovarian cycle, contributes to its normalization, reduces the strength and frequency of uterine contractions, reduces intrauterine pressure, against the background of which improves blood flow to the pelvic organs, and dysmenorrhea disappears or becomes less pronounced. However, when prescribing treatment for young women, consider the desire to become pregnant in the near future.
Pathogenetic drugs for the treatment of dysmenorrhea are non-steroidal anti-inflammatory drugs. Their action is based on the interruption of the main link of the pain syndrome - the blockade of the formation of prostaglandins and pro-inflammatory cytokines. The effectiveness of the use of drugs in this series reaches 80%. In addition, they have proven themselves quite well as an integrated treatment of chronic inflammatory diseases. Recently, preference has been given to selective cyclooxygenase blockers (nimesulide) over non-selective ones. The dosage and duration of the drug depends on the severity of the disease and the severity of symptoms, treatment is prescribed to prevent (a few days before the onset of menstruation) or relieve symptoms (with the appearance of pain).
To reduce the contractile activity of the myometrium, antispasmodics (no-spa), calcium channel blockers (verapamil) and magnesium preparations (magnesium B6) are used. The relaxation of smooth muscles under the action of these drugs occurs not only in the uterus, but also in other organs, in particular the stomach and intestines, which leads to the weakening of the accompanying symptoms of dysmenorrhea and positive polysystemic action. B vitamins have a positive effect on the nervous system, increasing resistance to pain stimuli.
Methods of psychotherapy and psychocorrection are quite effective, affecting the emotional sphere and eliminating the psychological factor of pain. Physiotherapeutic methods are also very popular.
In the treatment of secondary dysmenorrhea, in addition to all the above mentioned methods, it is imperative that therapeutic measures be taken regarding the underlying disease.
For the prevention of dysmenorrhea, you should properly organize a sleep and rest regime, avoid heavy physical exertion in the second half of the menstrual cycle, give up bad habits, not overwork, avoid excessive physical and mental stress. Good nutrition with a predominance of foods containing vitamins B1, B6 and E is one of the important components of the prevention of dysmenorrhea. During the month should refrain from the use of tonic drinks, chocolate and heavy fatty and salty foods. A few days before the menstruation, you can brew herbal diuretic and soothing teas, oregano, lemon balm, mint and chamomile have a good effect. Classes with moderate physical exertion, such as yoga or dancing, contribute to harmonious physical development, increase blood circulation in the pelvis and prevent the development of hypoxia.