What is dysmenorrhea?

The word "dysmenorrhea" often appears in people's lives, so what is dysmenorrhea? About 50% of young and middle-aged women will experience dysmenorrhea, which is the most common gynecological disease. The following experts will explain to you what dysmenorrhea is.

What is dysmenorrhea? Dysmenorrhea refers to cramping pain in the lower abdomen before, during or after menstruation, as well as general discomfort that seriously affects daily life. Women may experience mild abdominal pain, dizziness and other discomforts during or before and after menstruation, which is normal. However, if these discomforts become significantly more severe, affecting work and life and requiring treatment, it is called dysmenorrhea.

Dysmenorrhea can be divided into primary and secondary types.

1. Primary dysmenorrhea: There is no organic pelvic lesion, also known as functional dysmenorrhea. Primary dysmenorrhea begins after menarche and is mostly functional, more common in unmarried and childless young women. Primary dysmenorrhea has three characteristics that are important for diagnosis:

① Dysmenorrhea occurs almost exclusively during menstrual cycles with ovulation; dysmenorrhea usually occurs within the first few hours of the menstrual period, and the pain disappears within 2 to 3 days;

② The pain is in the area above the pubic symphysis in the lower abdomen, presenting as paroxysmal distending pain or spasmodic pain. It is also necessary to pay attention to psychological factors such as nervousness, uterine hypoplasia, and excessive anterior or posterior flexion of the uterus;

③ Membranous dysmenorrhea with tubular shedding of the endometrium. Pan Lingya et al. found in epidemiological studies that primary dysmenorrhea in women with menarche c5: 12 years old, menstruation > 7 days, and exercise during menstruation may cause endometriosis. Davis confirmed endometriosis in 49 cases of dysmenorrhea through laparoscopy. Schroeder et al. proposed that most cases of adolescent dysmenorrhea that are ineffective with painkillers are caused by endometriosis. Therefore, after diagnosing primary dysmenorrhea, it should be considered that some of them may have mild endometriosis.

2. Secondary dysmenorrhea: refers to dysmenorrhea caused by organic lesions in the pelvic cavity. Secondary dysmenorrhea occurs after a period of menstruation and is mostly organic. Common causes include endometriosis, pelvic inflammatory disease, wearing contraceptive rings, etc. The pain usually starts a few hours after menstruation, or 1 to 2 days before menstruation, and worsens during menstruation. It can be abdominal cramps, distending pain, and heavy pain. When the pain is severe, there may be nausea, vomiting, pale complexion, cold limbs, and even collapse.

Secondary dysmenorrhea manifests itself differently depending on the type of disease.

(1) Pelvic infection: Adnexitis, parametrial inflammation, etc. can cause dysmenorrhea during menstruation. However, pelvic pain can also occur during non-menstrual periods, and it is more severe during menstruation. When it is acute or subacute, the pain has nothing to do with the menstrual cycle.

(2) Endometriosis and adenomyosis: They often occur during the childbearing years. The characteristic of dysmenorrhea is progressive aggravation. Patients with severe cases also experience pelvic pain and dyspareunia. Painful nodules palpated at the uterosacral ligament during gynecological examination are of diagnostic value, and laparoscopy improves the accuracy of diagnosis. The characteristics of adenomyosis dysmenorrhea are similar to those of endometriosis, but uterine pain is the main symptom and the uterus may be enlarged. Ultrasound shows irregular uterine myometrium, which is of diagnostic value. It may be accompanied by menorrhagia.

(3) Uterine fibroids generally do not cause dysmenorrhea, but submucosal fibroids (with pedicles) occasionally cause dysmenorrhea. When fibroids are accompanied by dysmenorrhea, they may be accompanied by adenomyosis or adenomyoma. Uterine fibroids do not cause dysmenorrhea, but if dysmenorrhea occurs later, the patient should be checked for uterine fibroid degeneration. Ultrasound examination can assist in diagnosis.

Common secondary dysmenorrhea includes: endometriosis, adenomyosis, uterine fibroids, endometrial polyps, uterine adhesions, rudimentary horn of the uterus, pelvic inflammation (acute and chronic), cervical stenosis, imperforate hymen, and transverse vaginal septum.

The cause of primary dysmenorrhea is still unclear, but there are several possible factors:

(1) Endocrine factors: After ovulation, under the action of progesterone, the endometrium in the secretory phase can synthesize and release more prostaglandins, which can promote smooth muscle contraction and spasm, leading to uterine ischemia and dysmenorrhea. Most primary dysmenorrhea occurs during the menstrual period with ovulation.

(2) Uterine factors: Uterine hypoplasia can cause dysmenorrhea due to poor or uncoordinated uterine contractions. Uterine malformation, excessive uterine bending, and cervical stenosis and obstruction can cause poor menstrual blood flow and result in menstrual blood retention, thereby stimulating uterine contractions and causing dysmenorrhea.

(3) If the endometrium is shed in one piece, poor excretion can stimulate uterine contractions and cause dysmenorrhea, which is called membranous dysmenorrhea.

(4) A small number of patients experience fear and pain due to mental stress and insufficient understanding of menstrual physiology.

The degree of dysmenorrhea often varies from person to person. In addition to being related to the cause of dysmenorrhea, it is also related to the individual's sensitivity to pain to a certain extent.

Dysmenorrhea can be divided into primary and secondary types. Primary dysmenorrhea, also known as functional dysmenorrhea, refers to those who have obvious lesions in the reproductive organs, such as endometriosis, pelvic inflammatory disease, tumors, etc., when no obvious abnormalities in the pelvic organs are found after a detailed gynecological clinical examination.

Primary dysmenorrhea is one of the most common gynecological diseases in adolescent women. The incidence rate is between 30-50%. If the history of dysmenorrhea is long, you should consider whether it is secondary dysmenorrhea. Secondary dysmenorrhea can be caused by endometriosis, congenital uterine malformations (including bicornuate uterus, septate uterus, rudimentary uterine horn, vaginal septum, etc.), pelvic inflammation, adenomyosis, uterine fibroids, uterine polyps, uterine adhesions, cervical stenosis, ovarian cysts and pelvic congestion syndrome. Therefore, if a woman has severe dysmenorrhea and a long history, it is recommended to go to the hospital for examination to find out the cause as soon as possible.

Everyone knows what dysmenorrhea is. Experts suggest that young women can improve their physical fitness, which will help them to better deal with dysmenorrhea. Therefore, female friends should strengthen their exercise, improve their physical fitness, and enhance their ability to resist diseases.

In addition, women with dysmenorrhea should pay attention to their diet before menstruation, try not to drink cold water, and consider drinking some ginger water, which can also relieve the degree of pain.

Dysmenorrhea caused by female endocrine disorders is one of the problems that the world's medicine has not yet solved. (British) magazine reported that 90% of American women with cyclical menstruation have dysmenorrhea, and 36% have dysmenorrhea all the time or often. In the United States, dysmenorrhea is the most important reason for absence from work or inability to exercise.

According to a survey report by a British medical authority, 80% of women in the world have varying degrees of dysmenorrhea. Dr. Kennedy, a gynecologist at Oxford University, said at a meeting of the British Society for Scientific Achievement: "Two-thirds of women suffer from dysmenorrhea, and three-quarters of them cannot work due to the disease." As early as 1978, the National Women's Menstrual Physiological Constants Collaboration Group in my country conducted a survey and analysis of the menstrual physiological constants of more than 130,000 women in 29 provinces, municipalities and autonomous regions across the country. The proportion of dysmenorrhea was 33.19%, mild 45.73%, moderate .81%, and severe 13.55%. Primary dysmenorrhea accounts for 75% of girls. The incidence of dysmenorrhea at home and abroad has been rising every year, and the incidence of dysmenorrhea abroad is much higher than that in China.

The above is the expert's detailed explanation of what dysmenorrhea is. Women who want to avoid dysmenorrhea can go to the hospital to consult experts and use traditional Chinese medicine for treatment. I hope the above knowledge is helpful to you. If you still don't understand, please read the rest of the articles in this column or consult experts online to find the answers you want. I sincerely thank you for your support of this website.

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