Dysmenorrhea
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Between 40 and 60 % of women experience painful menstruation (dysmenorrhea, algomenorrhea), about 40 % of women report some discomfort in the second half of cycle (premenstrual cycle), pain in the middle of the cycle is less common (intermenstrual pain).
90 % of women experience some discomfort at least during one menstrual cycle. [1]
So, dysmenorrhea is a painful menstruation.
- between 5 and 10 % of women with dysmenorrhea have to visit a doctor and take sick leave;
- dysmenorrhea is more serious during an ovulatory cycle than during an anovulatory cycle.
Dysmenorrhea can be classified as:
- primary (functional, spastic) – begins immediately after menarche;
- secondary (organic) – later, as a sign or as a result of an underlying condition;
- dysmenorea membranacea – convulsive pain, a uterine mucosa discharges as a mucosal sac.
Primary dysmenorrhea[edit | edit source]
- Lower back pain, pain in a lower abdomen, frequently convulsive in the beginning of menstruation;
- often GIT signs (meteorism, vomiting), breast tenderness, migraine headache, polakisuria;
- cause – apparently uncoordinated functions of the uterus;
- increased production of prostaglandins increases contraction of the uterus and therefore the intrauterine pressure increases [1];
- more commonly found in asthenic women with vegetative dystonia and with hypoplasia of internal genital organs;
- we look for congenital malformations, cervical stenosis, hormonal disorder.
Secondary dysmenorrhea[edit | edit source]
- Onset usually after age 30
- Causes – endometriosis, result of the inflammation of internal genital organs (adhesion, uterus fixated in RVF ), stenosis and scars in uterus or on the cervix, tumors (especially submucosal myoma, cervical polyps).
- manifests primarily with pain, there are no total signs (algomenorrhea).
Diagnosis[edit | edit source]
- anamnesis, gynecological examination, hysterography, laparoscopy, …
Treatment[edit | edit source]
- secondary: based on the established cause and with consideration of age;
- primary: very difficult – NSAID, analgesics, spasmolytics, injection of pelvic plexuses;
- hormonal therapy – progesterons in second half of the cycle, blockade of ovulation with contraceptives;
- if there is a cervical stenosis – dilation.
