What methods are used for differential diagnosis of dysmenorrhea?

There are thousands of types of clinical diseases, and the symptoms of many diseases are very similar. Therefore, before treatment, differential diagnosis is needed to eliminate the interference of other diseases in order to diagnose the disease and formulate a corresponding treatment plan. Dysmenorrhea is a very common gynecological disease and is also a common situation in daily life. So, what methods are used for differential diagnosis of dysmenorrhea?

Patients with atypical medical history and unsatisfactory pelvic examination should undergo B-ultrasound scanning. If there are no positive signs in the pelvic examination and contraceptive drugs or PGs synthesis inhibitors are used and effective, primary dysmenorrhea can be diagnosed. If the medication is ineffective after 5 to 6 cycles, further laparoscopy or hysteroscopy should be performed to rule out organic lesions such as endometriosis and submucosal myoma.

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

1. Endometriosis

(1) Symptoms: dysmenorrhea and infertility.

(2) Gynecological examination and auxiliary examinations: Pelvic examination revealed endometriosis lesions; imaging examinations (pelvic ultrasound, pelvic CT and MRI) revealed endometriosis lesions, and serum CA125 levels were slightly to moderately elevated.

(3) Laparoscopic examination: Laparoscopic examination is currently the common method for diagnosing endometriosis. The diagnosis can be confirmed by observing typical lesions described in gross pathology or performing a biopsy on suspicious lesions under laparoscopy.

2. Adenomyosis

①Symptoms: dysmenorrhea; abnormal menstruation (which may manifest as excessive menstruation, prolonged menstruation and irregular bleeding);

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

Dysmenorrhea is a common symptom among women. Dysmenorrhea before marriage will disappear naturally after getting older, especially after marriage and childbirth, and no treatment is needed. Except for individual cases. However, those who have dysmenorrhea pain for up to 3 days and whose life is affected should be treated. The treatment of primary dysmenorrhea is mainly symptomatic treatment, mainly pain relief and sedation.