The principle of dysmenorrhea

Written by Tao Zhong E
Obstetrics and Gynecology
Updated on September 18, 2024
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Dysmenorrhea generally refers to lower abdominal pain during menstruation. There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea involves no substantive lesions; that is, no problems can be identified through examinations, yet menstrual pain occurs. This type is generally due to internal inflammatory factors and pain mediators, such as an increased secretion of prostaglandins, making the pain more pronounced. Secondary dysmenorrhea generally refers to organic lesions, such as adenomyosis or endometrial cysts. In these cases, noticeable menstruation pain also occurs due to organic lesions leading to an increased secretion of pain mediators.

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What should I do if I have severe menstrual cramps?

In clinical practice, dysmenorrhea can be divided into primary dysmenorrhea and secondary dysmenorrhea. If the patient has primary dysmenorrhea, there are no specific effective treatment plans available clinically. It is recommended that the patient take oral painkillers to alleviate the symptoms of dysmenorrhea. If it is secondary dysmenorrhea, the patient needs to immediately undergo gynecological ultrasound and examinations at a local hospital to determine the cause of the dysmenorrhea. Once the cause is identified, an effective treatment plan can be developed based on the cause. Once the cause is addressed, the symptoms of dysmenorrhea will naturally be alleviated.

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What causes menstrual cramps?

Dysmenorrhea is divided into primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to menstrual pain that occurs without organic lesions in the uterus. It is caused by the increase of prostaglandin levels in the body during menstruation, which stimulates uterine contractions. Secondary dysmenorrhea is caused by organic pathological changes in the uterus itself, such as endometriosis, adenomyosis, and pelvic inflammatory disease, which stimulate uterine contractions and lead to lower abdominal pain during menstruation.

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Causes of Dysmenorrhea

The general causes of dysmenorrhea include endometriosis or cold in the uterus, or stagnation of qi and blood stasis, all of which can lead to painful menstruation. Clinically, if dysmenorrhea is generally mild abdominal discomfort without affecting study or work, this mild dysmenorrhea is generally not a big problem. If dysmenorrhea shows a gradually worsening trend, it generally requires a visit to the hospital for a color ultrasound to check for endometriosis. If dysmenorrhea caused by endometriosis is present, it will show a worsening trend and in severe cases, may include symptoms of nausea and vomiting, so this situation is generally caused by a displacement of the endometrial lining. Additionally, some patients may experience cold hands and feet, and cold abdominal pain during the painful menstruation, which is mostly considered to be caused by cold in the uterus. Furthermore, stagnation of qi and blood stasis can also lead to dysmenorrhea, typically presenting with blood clots during menstruation, where pain relief follows the discharge of blood clots, suggesting a high possibility of being caused by stagnation of qi and blood stasis.

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Is it normal to have painful periods?

Dysmenorrhea is generally abnormal. Under normal circumstances, if menstruation involves ovulation, there may be slight discomfort in the lower abdomen during menstruation, which is considered normal. If dysmenorrhea is present and tends to worsen over time, this condition usually indicates the possibility of endometriosis. In such cases, it is essential to visit a hospital for a color ultrasound and a CA125 blood test to confirm if the pain is caused by endometriosis, and treatment should be based on the diagnostic results. Furthermore, if dysmenorrhea is caused by a cold uterus, symptoms might include pain accompanied by a cold sensation in the lower abdomen and cold extremities. In this case, it is typically necessary to take medicine that warms the meridians, dispels cold, and alleviates pain in the uterus. If dysmenorrhea is due to qi stagnation and blood stasis, one can take medicine that promotes blood circulation, removes blood stasis, and relieves pain in the meridians. Therefore, dysmenorrhea is not normal.

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The harm of dysmenorrhea

Some women experience severe dysmenorrhea, where the pain can radiate to the root of the thigh, affecting their normal sleep and concentration during the day, which in turn affects their work efficiency. Some women experience such severe dysmenorrhea during their menstrual period that they even need to take leave from work to rest at home. Additionally, some women may suffer from secondary dysmenorrhea, which is linked to underlying diseases. For example, conditions like adenomyosis, endometriosis, and endometrial polyps can alter the internal environment of the uterine cavity and change its coagulation state, leading to increased menstrual flow. This can cause anemia due to blood loss and also affect normal pregnancy.