Painful menstruation, called the menstrual contractions - a suprapubic pain that occurs just before menstruation and during it.
The frequency of observations - 40% of adult women.
Causes
- Increased production of prostaglandins and other biologically active substances causing a decrease uterine perfusion, spasmodic contraction of uterine muscle fibers;
- Congenital malformations of the uterus and vagina;
- Cervical narrowing;
- endometriosis;
- Tumors of the pelvic organs (especially leiomyoma).
Manifestations painful menstruation
- Mild - discomfort, mild pain compressive nature, heaviness in the suprapubic region in the 1st day of menstruation, there are no other symptoms.
- Average degree - discomfort in the first 2-3 days of menstruation, unexpressed pain, accompanied by a slight indisposition, diarrhea, Headache.
- Severe - intense cramping pain for 2-7 days, the pain in the lumbar region, hips, headache.
Painful menstruation begins at the same time and continue to 1-3 days, pain, cramping or throbbing, localized in the lower abdomen, often radiates to the back and the front surface thighs. Sometimes the pain occurs for 1-2 days before menstruation, the character depends on the specific causes (endometriosis, urinary tract infections, and so on. D.)
Survey Methods - ultrasound screening for diseases, sexually transmitted diseases.
Treatment
- If the pain during menstruation caused by infection, endometriosis or other disease - treatment of infections; suppression of endometrial growth with suspected endometriosis.
- Transcutaneous electrical nerve stimulation.
- Surgical treatment: the amount of operation depends on the degree of localization of endometriosis and its distribution; with adenomyosis - supravaginal amputation of the uterus or cervix.
- Ibuprofen 400-600 mg every 4-6 hours or naproxen at 550 mg every 12 hours.
- Oral contraceptives: the three-merci, marvelon, Mersilon, Janine, Diane-35 - selected individually gynecologist.
- In endometriosis - buserelin 0.2% 150 micrograms into each nostril 3 times a day (a total of 900 micrograms per day).
- In severe - gestrinone 2.5 mg 2 times a week to 6 months.
Forecast
Improvement in painful menstruation occurs with age, especially after childbirth.
