Lower abdominal pain before and after menstruation

Before menstruation, women's bodies will also show many symptoms, among which breast tenderness and lower abdominal pain are the two most obvious symptoms. Therefore, if a female friend experiences lower abdominal pain before her period, she does not need to worry too much. But some women experience lower abdominal pain before and after their menstrual periods. Is this a normal phenomenon?

Menstruation is the regular shedding of the endometrium due to the influence of hormone levels in the body. Generally, before and during menstruation, the uterine smooth muscle will contract, and the shedding of the endometrium may cause abdominal pain, etc. According to the situation you described above, it may be a normal pre-menstrual reaction. It is recommended that you keep your abdomen warm, do not eat spicy and cold food, and also pay attention to the hygiene below. Closely observe whether your menstrual volume, menstrual period, menstrual color, etc. are normal. If you are worried, it is best to go to the hospital for a color ultrasound to check the situation in the uterine pelvic cavity to rule out the possibility of chronic inflammation.

It is caused by poor blood circulation, qi stagnation and blood stasis, but the possibility of inflammatory infection cannot be ruled out.

Dysmenorrhea is divided into primary and secondary. A complete medical history, age of onset, disease progression, nature of the disease, and associated symptoms are helpful in differential diagnosis. The absence of positive signs in gynecological examination is the key to diagnosing primary dysmenorrhea, but there may be no positive signs in the early stages of secondary dysmenorrhea. Ultrasound, hysterosalpingography, and hysteroscopy can help understand the condition of the uterus and its appendages; laparoscopy can directly visualize pelvic lesions and perform biopsies.

1. Primary dysmenorrhea Dysmenorrhea without organic pelvic lesions, also known as functional dysmenorrhea, has three characteristics that are important for diagnosis: ① Dysmenorrhea almost always occurs during the menstrual cycle with ovulation; dysmenorrhea mostly occurs in the first few hours of the menstrual period, and the pain disappears within 2 to 3 days; ② The pain is in the lower abdomen above the pubic symphysis, presenting as paroxysmal distension or spasmodic pain. Attention should also be paid to psychological factors such as tension, uterine hypoplasia, and excessive anterior and posterior flexion of the uterus; ③ Membranous dysmenorrhea with tubular shedding of the endometrium. Pan Lingya and other epidemiological studies have found that menarche c5: 12 years old, menstruation ＞7 days, primary dysmenorrhea in those who exercise during menstruation may cause endometriosis. Davis confirmed endometriosis through laparoscopy in 49 patients with dysmenorrhea aged 16.6 to 1.4 years. 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 patients may have mild endometriosis.

2. Secondary dysmenorrhea refers to dysmenorrhea caused by organic pelvic lesions. The manifestations vary depending on the type of disease.

(1) Pelvic infection: adnexitis, parametrial tissue inflammation, etc. can cause dysmenorrhea during menstruation. However, pelvic pain also occurs during non-menstrual periods and is aggravated during menstruation. In acute and subacute attacks, the pain is not related to the menstrual cycle.

(2) Endometriosis and adenomyosis: often occur during the childbearing age. The characteristic of dysmenorrhea is that it progressively worsens. Patients with more severe symptoms also often experience pelvic pain and pain during sexual intercourse. Gynecological examination can palpate painful nodules at the uterosacral ligament, which has diagnostic value, and laparoscopy improves the accuracy of diagnosis. The symptoms of adenomyosis dysmenorrhea are similar to those of endometriosis, but uterine pain is the main symptom and the uterus may enlarge. Ultrasound shows irregularities in the myometrium, which is of diagnostic value. May be accompanied by menorrhagia.