Lower abdominal pain before period

What women eat is responsible for the task of childbirth. The arrival of menstruation marks the beginning of ovulation and the emergence of reproductive function in women. Women should be careful not to touch cold water or hold grudges before and after menstruation, otherwise dysmenorrhea may easily occur. Some women experience lower abdominal pain before menstruation. Traditional Chinese medicine believes that the causes are as follows: blood deficiency and blood stasis. Lower abdominal pain before menstruation can even make women so painful that they cannot stand upright.

Menstruation is one of the most common gynecological symptoms, which refers to lower abdominal pain and distension before, during, or after menstruation, accompanied by back pain or other discomfort, and the symptoms seriously affect the quality of life. Dysmenorrhea is divided into two categories: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to dysmenorrhea without organic lesions of the reproductive organs; secondary dysmenorrhea refers to dysmenorrhea caused by organic pelvic diseases, such as endometriosis and adenomyosis.

Causes

1. The occurrence of primary dysmenorrhea is mainly related to the increase in endometrial prostaglandin content during menstruation. Elevated PGF2α levels are the main cause of dysmenorrhea. High levels of PGF2α can cause excessive contraction of uterine smooth muscle and vascular spasm, resulting in uterine ischemia and hypoxia and dysmenorrhea.

2. Increase in substances such as vasopressin, endogenous oxytocin and β-endorphin.

3. Mental and neurological factors.

4. Secondary pain is often caused by endometriosis, adenomyosis, etc.

Clinical manifestations

1. Primary dysmenorrhea is more common in adolescence, often occurring within 1 to 2 years after menarche. The main symptom is lower abdominal pain that occurs regularly during the menstrual cycle. The symptoms of secondary dysmenorrhea are the same as those of primary dysmenorrhea. Secondary pain caused by endometriosis often progressively worsens.

2. The pain usually starts after menstruation, and the earliest appearance is 12 hours before menstruation. The pain is most severe on the first day of menstruation and lasts for 2 to 3 days before being relieved. The pain is often spasmodic. It is usually not accompanied by abdominal muscle tension or rebound pain.

3. It may be accompanied by symptoms such as nausea, vomiting, diarrhea, dizziness, fatigue, etc. In severe cases, the face will turn pale and cold sweats will occur.

4. No abnormalities were found during gynecological examination.

diagnosis

The diagnosis can be made clinically based on lower abdominal pain during menstruation and no positive signs during gynecological examination.

Differential Diagnosis

It needs to be differentiated from secondary dysmenorrhea caused by endometriosis, adenomyosis, and pelvic inflammatory disease.

1. Endometriosis

(1) Symptoms: dysmenorrhea and infertility.

(2) Gynecological examination and auxiliary examinations: Pelvic examination revealed endometriosis lesions; imaging examinations (pelvic ultrasound, pelvic CT and MRI) revealed endometriosis lesions, and serum CA125 levels were slightly to moderately elevated.

(3) Laparoscopy: Laparoscopy is currently the common method for diagnosing endometriosis. The diagnosis can be confirmed by observing typical lesions described in gross pathology under laparoscopy or by performing a biopsy on suspicious lesions.

2. Adenomyosis

①Symptoms: dysmenorrhea; abnormal menstruation (which may manifest as excessive menstruation, prolonged menstruation and irregular bleeding);

② Gynecological and auxiliary examinations: uterine enlargement, tenderness, etc.; imaging examinations (pelvic B-ultrasound), serum CA125, etc.

treat

Dysmenorrhea is a common symptom among women. Dysmenorrhea before marriage will naturally disappear when you are older, especially after marriage and childbirth, and there is no need for treatment. Except in individual cases. However, if the pain of dysmenorrhea lasts for more than 3 days and affects one's life, treatment should be given. The treatment of primary dysmenorrhea is mainly symptomatic treatment, with analgesia and sedation as the main focus.

1. General treatment

(1) Pay attention to psychological treatment and eliminate tension and worries.

(2) Get enough rest and sleep, exercise regularly and moderately, and quit smoking.

(3) When the pain is unbearable, supplement with medication.

2. Medication

(1) For dysmenorrhea caused by adenomyosis in women who do not desire pregnancy, Mirena is the first choice.

(2) Oral contraceptives: Suitable for women with dysmenorrhea who require contraception, with an effectiveness rate of over 90%.

(3) Over-the-counter drugs: acetaminophen, acetaminophen plus pamabrom, and vinyl salicylic acid (aspirin).

prevention

1. Keep warm during menstruation to avoid catching cold and menstrual cold.

2. Avoid cold drinks and cold foods during menstruation. Swimming, tub bathing and cold water bathing are prohibited during menstruation.

3. Keep the vagina clean and maintain hygiene during menstruation.

4. Regulate your emotions, keep your mind relaxed, and eliminate fear.

5. If severe dysmenorrhea or even fainting occurs, you should keep warm first and then take antispasmodics and analgesics.

6. Drink more hot milk. For example, drinking a glass of hot milk with a spoonful of honey before going to bed every night can relieve dysmenorrhea.

7. Practicing yoga, bending over, relaxing and other movements can relax muscles and nerves, and improving physical fitness can help improve menstrual pain.

8. Actively and correctly examine and treat gynecological diseases. Try to avoid unnecessary gynecological examinations and various surgeries during menstruation to prevent bacterial ascending infection. If you suffer from gynecological diseases, you should actively seek treatment to eliminate the hidden dangers that cause dysmenorrhea.