Dysmenorrhea - a pathological process characterized by severe pain during menses, absent for the rest of the cycle. There are two types of violations: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is diagnosed when the causes painful menstruation are not revealed. Dysmenorrhea occurs in 45-60% of women of childbearing age. For the first time dysmenorrhea may occur in the first ovulatory menstrual cycles, significantly reducing the level of vitality and health of women. Dysmenorrhea is more common in women asthenic constitution, prone to loss of consciousness, excitable. The disease is also common for patients with vascular dystonia and asthenic-neurotic syndrome.
Primary dysmenorrhea - functional menstrual disorders not caused by pathological processes in the pelvic organs. Primary dysmenorrhea develops in adolescence and can occur both during the first menstrual cycle, and after 1-3 years after the onset of menstruation. As a rule, the pain of dysmenorrhea so tolerant with age may increase pain. In accordance with the nature and severity of pain in primary dysmenorrhea distinguish two forms: the compensated and uncompensated dysmenorrhea.
Compensated dysmenorrhea is characterized by constancy of pain over time, while the uncompensated dysmenorrhea is characterized by pain is amplified over time. As a rule, the second form of dysmenorrhea patients can not do without skilled medical care.
The pain of dysmenorrhea may occur for 1-2 days prior to menstruation, and continue through the first days of the menstrual cycle. In most cases, dysmenorrhea pain are cramping, aching, pulling character. In rare cases, there is pain Expander nature, radiating into the rectum, the bladder, the appendages.
Secondary dysmenorrhea - pathological process caused by the disruption of the functioning of the pelvic organs, inflammation, gynecological diseases. Secondary dysmenorrhea usually diagnosed in patients after 30 years. Secondary dysmenorrhea is found in 27-33% of the total number of diagnosed diseases, it is more complicated. In secondary dysmenorrhea period of loss of working capacity of the patient is greatly increased. Pain starts in about a day before the expected menstruation. This type of dysmenorrhea is characterized by heavy menstrual bleeding with the presence of a large number of clots, severe pain in the lumbar region.
Dysmenorrhea: Causes of disease
In primary dysmenorrhea causes of violations can be both physiological and psychological. When the cause of dysmenorrhea pain may develop PGE2 (prostaglandin E2) and PGE2-alpha (prostaglandin E2-alpha), contributing to the contraction of smooth muscles and enhancing pain. In primary dysmenorrhea form causes may lie in the violation of hormonal background.
Psychological causes of development and strengthening of pain in dysmenorrhea during menstruation is the fear of pain patients. So, needless waiting for pain exacerbates the perception.
In secondary dysmenorrhea causes of violations of the form may become:
- Expansion of the pelvic veins;
- Inflammatory diseases of the pelvic organs;
- Tumours of the pelvic organs;
- Of adhesions after surgery;
- Hormonal disorders in the body;
- intrauterine device;
- Diseases transmitted through sexual contact.
Dysmenorrhea: symptoms of the disorder
Each of the forms of dysmenorrhea is characterized by complex symptoms, according to which the diagnosis. When the primary form of dysmenorrhea symptoms are as follows:
- The pains of different nature;
- Nausea, vomiting, dizziness, weakness;
- Increased body temperature;
- Red spots on the skin of hands, neck and face;
- Heart rhythm disorders;
- Sleep disorders, insomnia.
These symptoms of dysmenorrhea due to increased levels of the hormones epinephrine, dopamine, norepinephrine and adrenergic determine the type of dysmenorrhea.
Also, when the symptoms of dysmenorrhea can be caused by increased levels of the hormone serotonin, which leads to:
- Reduced heart rate;
- Vomiting, diarrhea;
- Lowering body temperature.
These symptoms define the parasympathetic type of dysmenorrhea.
In secondary dysmenorrhea symptoms may be supplemented with symptoms of the underlying disease that causes painful menstruation.
In some cases, dysmenorrhea symptom is painful sexual intercourse.
Diagnosis of dysmenorrhea
The main methods of diagnosis of dysmenorrhea is the clinical picture and the patient's complaint to the characteristic pain. Also, to avoid possible causes of dysmenorrhea performed pelvic ultrasound, Pap analysis of hormonal status, hysteroscopy (examination of the walls of the uterus using a special device allows to detect any intrauterine abnormalities carried out in the hospital), laparoscopy (examination of the abdominal cavity using a special device, surgical procedure, which is performed in a hospital).
Dysmenorrhea: the treatment of the disease
Dysmenorrhea treatment may be conservative (medical drugs) and radical (surgically) character. When conservative methods of treatment of dysmenorrhea is aimed at pain relief, as well as their causes. In some cases, a symptomatic treatment of dysmenorrhea.
There are three types of medical treatment of dysmenorrhea:
- Progestin - a group of hormones that contribute to tissue renewal of the mucous membrane of the uterus, relax the muscles of the uterus, regulating the formation of estrogens;
- Hormonal contraceptives - in most cases, dysmenorrhea used combined oral contraceptives suppress ovulation and helps to reduce production of prostaglandins. This reduces the intrauterine pressure is decreased the amplitude and frequency of contractions of the uterine muscle that promotes elimination of pain;
- Nonsteroidal anti-inflammatory drugs - are assigned to patients who are contraindicated for some reason progestins and hormonal therapy. When this type of treatment of dysmenorrhea drugs is temporary (during menses), as opposed to OK and progestogens, which are accepted on an ongoing basis.
Surgical techniques are used only in acute endometriosis, inflammation of genitals, genital defects of the structure (the narrow channel of the cervix).