Severe dysmenorrhea after transplantation

After the transplant operation, many female friends will obviously feel that their menstrual cramps become very severe every time they have their menstruation. At this time, the real reason should be found. It is mostly caused by the low resistance of female friends. In addition, attention should be paid to the possible complications such as nausea, vomiting and diarrhea, and treatment should be carried out according to the symptoms.

In women with primary dysmenorrhea, increased uterine activity is partly due to an imbalance of ovarian hormones, which may be caused by increased estrogen levels during the luteal phase and premenstrual period. Estrogen can stimulate the synthesis and release of PGF2a and vasopressin. Oral contraceptives may inhibit uterine activity by changing the imbalance of ovarian hormones. It was once believed that progestin activity was an important factor in the treatment of dysmenorrhea. However, studies in recent years have confirmed that various estrogen-progestin combined contraceptives can reduce the occurrence of dysmenorrhea, but there is no significant difference in the effect of reducing the severity of dysmenorrhea.

Prostaglandin synthase inhibitors can be used as non-steroidal anti-inflammatory drugs (NSAIDs) for patients with primary dysmenorrhea who do not need to seek contraceptive measures or who are not well responded to oral contraceptives. They are prostaglandin synthase inhibitors that inhibit PG synthesis by blocking the cyclooxygenase pathway, thereby reducing uterine tension and contractility, achieving the effect of treating dysmenorrhea.

Since the 1970s, it has been widely used to treat primary dysmenorrhea due to its good effect (effectiveness 60% to 90%). It is a simple menstrual medication taken for 2 to 3 days with few side effects. NSAIDs can not only relieve pain, but also relieve related symptoms; such as nausea, vomiting, headache, diarrhea, etc. Side effects are generally mild and uncommon and generally tolerated. They are mainly gastrointestinal and central nervous system symptoms such as indigestion, nausea, anorexia, heartburn, diarrhea, constipation, headache, dizziness, irritability, and drowsiness; more serious side effects include skin reactions, bronchospasm, temporary renal impairment, etc., which are very rare.

Generally, the medication is started after the onset of menstruation and pain, and is taken for 2 to 3 consecutive days. Because prostaglandins are released most in the first 48 hours of menstruation, the purpose of continuous medication is to correct the biochemical imbalance of excessive synthesis and release of PG in menstrual blood. If the medication is not given continuously in the first 48 hours but is given intermittently when pain occurs, it will be difficult to control the pain. Premenstrual preventive medication has a similar effect to that started after menstruation. If there is still a certain degree of pain within the first few hours after starting the medication, it means that the first dose of the next cycle should be doubled, but the maintenance dose remains unchanged.

Experiments on calcium channel blockers have shown that nifedipine (nifedipine) can significantly inhibit uterine contractions caused by oxytocin. This product has low toxicity, few side effects, is safe and effective, and has been used in small domestic open clinical trials for premenstrual administration (5-10 mg, 3 times/d for 3-7 days) or sublingual administration of 10 mg when in pain, and most have achieved good results. The side effects include headache, palpitations, etc., and blood pressure should be paid attention to.

Traditional Chinese medicine believes that pain is caused by poor circulation of qi and blood. The treatment of primary dysmenorrhea focuses on regulating qi and blood. The warm uterus care cream composed of angelica, peony root, Chuanxiong Poria cocos, Atractylodes macrocephala and Alisma orientalis is effective in treating primary dysmenorrhea and can reduce the level of PGF2a in the blood.