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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.

Links[edit | edit source]

Related Articles[edit | edit source]

References[edit | edit source]

  1. a b

Source[edit | edit source]

Kategorie:Gynekologie Kategorie:Patologie Kategorie:Heslo Kategorie:Vnitřní lékařství Kategorie:Endokrinologie Kategorie:Interní propedeutika