Algodismenorrhea - painful periods: causes and treatment. Algodysmenorrhea (painful menstruation) - physiological norm or pathology

Algodismenorrhea is an unpleasant pulling pain in the lower abdomen and in the lumbar region before the onset of critical days, which can last until the end of menstruation. According to ICD-10, the code for this pathological condition is recorded on the sick leave as 94.4 in the event that the violation manifested itself for the first time. The secondary manifestation of the pathology is recorded as 94.5. If this violation has an unspecified etiology, then its ICD-10 code will be written as 94.6.

Causes

By definition in healthy body algomenorrhea should not be, so it is important to understand the causes of this disease. In the first place among the causes of pain, you can put inflammatory processes that occur in the genital organs (vagina, uterus, tubes, ovaries). The list of causes of inflammatory diseases themselves is quite extensive: an elementary cold, hypothermia, infectious diseases, the consequences of an abortion, cysts, various neoplasms, etc. But do not be afraid, because algomenorrhea, in the first place, is a signal to pay attention to the state of your body. During menstruation, the uterus swells and increases in size, so it begins to put pressure on other organs of the small pelvis. Going to the gynecologist and examination with ultrasound diagnostics help to identify or eliminate the causes of an inflammatory disease.

The second reason for premenstrual pain may be psychological. The girl is infantile and not ready for adulthood, and on a psychological level rejects his growing up. Primary algomenorrhea is caused, as a rule, by the desire to stay longer as a child. This desire is inherent in every person, but growing up is inevitable, and it is necessary to find positive aspects at every age.

The support of a loving mother and timely information about the critical days during puberty will help the girl to easily overcome these difficulties.

If after the first menstruation the pain is severe enough and lasts more than three to four months, there is cause for concern. In this case, you should consult a doctor, because the sooner the cause is found out, the easier it will be to eliminate it. Treatment, as a rule, consists in psycho-correction, which allows the girl to feel like a woman.

The underlying reason for painful periods may be fear or unwillingness to become pregnant. Fortunately, modern pharmaceutical industry today can offer a whole arsenal of tools to help avoid unwanted pregnancies.

More often psychological aspect it is the primary algomenorrhea that is generated, therefore it can be stated with a considerable degree of certainty that this violation is not associated with pathology or any disease.

Another reason is the presence of pathology, for example, the bend of the uterus. There is no inflammatory process, but algomenorrhea is present. Again, at the appointment with the gynecologist, you can identify this pathology and try to eliminate this cause of painful menstruation, since in the future it can develop precisely because of the incorrect position of the uterus in the body.

Clinical manifestations

Symptoms of such a disorder as primary algomenorrhea are not as pronounced as in secondary pathology. Therefore, the diagnosis of the disease in this case is difficult.

The main symptoms of secondary algomenorrhea depend on the cause of the development of the disorder in the patient. Yes, the most obvious symptoms in this violation, it is:

• pain in the lower abdomen, which occurs a few hours before the onset of menstruation and can last several days, and sometimes until the end of menstruation;
• plentiful menstrual flow;
• general health disorders headache, weakness, increased fatigue, sleep disturbance and lack of appetite).

In some cases, the symptoms are supplemented fever body, which can be increased slightly (subfebrile condition) or to febrile indicators.

Also, the symptoms of algomenorrhea can be supplemented by symptoms of inflammatory or dystrophic processes in the pelvic organs:

• copious discharge from the vagina;
• itching and burning in the genitals;
• pain during sexual contact;
• swelling of the labia and other symptoms.

Therefore, before prescribing treatment, the doctor must carefully examine the patient in order to exclude the possibility of her having other diseases that cause pain.

Treatment of algomenorrhea

During the examination, the attending gynecologist will find out the cause and prescribe complex treatment. In addition to painkillers, the list of treatments may include: unconventional method like brisk daily walking. This is because many inflammatory diseases often occur against the background of congestion in the pelvic organs, and during physical exertion, they are intensively enriched with oxygen, which helps to eliminate inflammation. In the event that this is a primary algomenorrhea, treatment will include not only physical exercise, normalization of lifestyle and taking painkillers, but also a consultation with a psychologist.

Before going to the doctor, you can check at home if there are inflammatory processes in genitourinary system. The first test is a litmus test, sold at any pharmacy, and sometimes attached to packs with gaskets. As a rule, a pH shift to the acidic side indicates the presence of fungi and pathogenic microflora, and as a result, the presence of an inflammatory process in the genitourinary system. A simple douche with chamomile and washing with a weak soda solution will partially return the pH to the correct range.

Treatment of such a disorder with medications consists in taking analgesics and antispasmodics. This is the case if the causes of the pathology are not identified and are purely psychosomatic in nature. If it is established that a woman suffers from some inflammatory diseases of the genital area, antibiotic treatment may be required (the sensitivity of microorganisms to them is first determined).

Also, according to indications, taking into account the causes of such a disorder as algomenorrhea, and its symptoms, the doctor may prescribe physiotherapeutic procedures.

What is Algodysmenorrhea (dysmenorrhea)

Algodysmenorrhea (dysmenorrhea) is a cyclically recurring pain syndrome that accompanies menstrual rejection of the endometrium. The frequency of algomenorrhea ranges from 8 to 80%. With algomenorrhea, disability and changes in psychosomatic status are possible, and therefore it is not only medical, but also social problem.

Pathogenesis (what happens?) during Algodysmenorrhea (dysmenorrhea)

There are primary, or functional, algomenorrhea, not associated with anatomical changes in the internal genital organs, and secondary, due to pathological processes in the pelvic organs.

Primary alyodysmenorrhea appears in adolescence 1 - 1.5 years after menarche, with the onset of ovulation, usually in girls with an asthenic physique, excitable and emotionally labile. Prerequisites for primary algomenorrhea:

• insufficiency of the luteal phase;
• insufficient level of endogenous opiates (endorphins, enkephalins);
• functional failure of endometrial tissue proteolytic enzymes and impaired fragmentation of the falling off uterine mucosa;
• excessive content of prostaglandins due to the inferiority of lipid peroxidation.

Most researchers associate the occurrence of primary algomenorrhea with high level prostaglandins E2 and F2 and / or an increase in their relative amounts in the menstrual endometrium. Prostaglandins E2 and F2 are powerful stimulants contractile activity myometrium. During menstruation, integrity disorders cell membranes and rejection of the endometrium contribute to the release of prostaglandins into the intercellular space, their content in menstrual blood increases. Vasospasm and local ischemia lead to impaired hemodynamics of the small pelvis: venous congestion promotes cell hypoxia, accumulation of allogeneic substances, irritation nerve endings and the occurrence of pain. The pain is aggravated by the accumulation of calcium salts in the tissues: the release of active calcium increases intrauterine pressure, amplitude and frequency of uterine contractions.

A significant role in the reaction of a woman to increased spastic contractions of the uterus during menstruation is played by pain sensitivity. Extensive fields of pain receptors are localized mainly in the thalamus. The pelvic and celiac nerves, which include afferent fibers from the cervix and body of the uterus, are represented in the thalamus. The intensity of pain sensation is due to neurotransmitters - endogenous opiates and depends on the type of autonomic nervous activity, mental state, emotional background etc. Pain threshold in to a large extent determined by the synthesis of endogenous opiates. Strong motivation and willpower, switching attention to any activity can ease the pain or even suppress it.

Symptoms of Algodysmenorrhea (dysmenorrhea)

Cramping pains during the days of menstruation or a few days before it are localized in the lower abdomen, radiating to the lower back, less often to the area of ​​​​the external genitalia, groin and thighs. The pains are paroxysmal and quite intense, accompanied by general weakness, nausea, vomiting, spastic headache, dizziness, fever up to 37-38 ° C, dry mouth, bloating, fainting and other autonomic disorders. Sometimes any one symptom becomes the leading one, it worries more than pain. Severe pain depletes the nervous system, contributes to the development asthenic condition, reduce the ability to work.

Diagnosis of Algodismenorrhea (dysmenorrhea)

Diagnosis of primary algomenorrhea is based on:

• characteristic constitutional features, young age patients, the appearance of algomenorrhea 1.5-2 years after menarche;
• accompanying algomenorrhea vegetative-vascular symptoms;
• absence anatomical changes during gynecological examination;
• asthenic physique, tendency to lose weight.

Treatment of Algodismenorrhea (dysmenorrhea)

Treatment of primary algomenorrhea should be comprehensive.

It includes:

• prostaglandin synthesis inhibitors. It is necessary to take into account their effect on the gastric mucosa and platelet aggregation and prescribe non-steroidal anti-inflammatory drugs in suppositories. The most commonly used are indomethacin 25 mg 3 times a day, naprosin 250 mg 2-3 times a day, brufen 200 mg 3 times a day, aspirin 200 mg 4 times a day. The expediency of using these drugs within 48-72 hours after the onset of menstruation is determined by the fact that prostaglandins are released in maximum quantities in the first 48 hours from the onset of menstruation;
• antispasmodics, analgesics (as antispasmodic therapy);
• combined estrogen-progestin preparations with great content gestagens or more active gestagens from the 5th to the 25th day of the menstrual cycle, 1 tablet for at least 3 months (the mechanism of their action is not clear enough, perhaps combined contraceptives, inhibiting the growth of the endometrium, contribute to a decrease in the synthesis of prostaglandins in it);
• sedatives in accordance with the severity of neurovegetative disorders from herbal preparations to tranquilizers (valerian, relanium, trioxazine);
• homeopathic remedies (remens, mastodinone, menalgin, etc.);
• non-drug treatment - physio- and acupuncture: novocaine electrophoresis on the area solar plexus 8-10 procedures every other day during the cycle, Shcherbak collar with bromine, ultrasound, DDT and SMT;
• vitamin therapy - vitamin E 300 mg per day in the first 3 days of painful menstruation;
• correct mode of work and rest; sports that promote harmony physical development(swimming, skating, skiing).

Which doctors should you contact if you have Algodysmenorrhea (dysmenorrhea)

Gynecologist

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Algodysmenorrhea (algomenorrhea, dysmenorrhea) is a cyclically recurring pathological process, which is manifested by painful menstruation and is accompanied by a violation of the general condition of a woman.
According to various researchers, the frequency of dysmenorrhea ranges from 8 to 80%.

Classification of dysmenorrhea

I. Primary algomenorrhea - is functional.
II. Secondary algomenorrhea - develops against the background organic damage genitals.

Etiopathogenesis of dysmenorrhea

The most common causes of primary algomenorrhea are:
1. Endocrine: the cause of spastic contractions of the uterine muscle, causing its ischemia, is an increase in the synthesis and a weakening of the processes of degradation of prostaglandins.
2. Neuropsychogenic: algodysmenorrhea is often observed with lability nervous system with a decrease in pain threshold.
3. Mechanical: lead to difficulty in the outflow of menstrual blood from the uterus. These reasons include incorrect positions of the uterus.
4. Constitutional: with infantilism, there is hypoplasia of the uterus, poor development of muscle elements that are difficult to stretch during menstrual plethora, resulting in irritation of the nerve endings and the occurrence of pain.

The causes of the development of secondary algomenorrhea are most often the following diseases:

1. Internal and external genital endometriosis. With endometriosis painful menstruation due to the fact that endometrioid heterotopias undergo cyclic changes similar to the endometrium. In this case, in the process of desquamation, irritation occurs
a large number of interoreceptors of the uterus, peritoneum and other organs affected by endometriosis, which leads to the release of prostaglandins and the appearance of a pronounced pain syndrome.

2. Uterine fibroids. With a submucosal location, the nodes can be a mechanical obstacle to the outflow of menstrual blood, leading to increased uterine contractions and, consequently, to pain.

3. Inflammatory diseases internal genital organs. Inflammatory processes, especially chronic ones, lead to the development adhesive process and violation of the correct location of the uterus in the pelvis. The presence of infiltrates in the pelvis and parametric tissue is also common cause algomenorrhea.

4. The presence of the IUD contributes to increased synthesis of prostaglandins.

5. Allen-Masters syndrome. Ruptures of the posterior leaf of the broad ligament and varicose veins at the base of the broad ligament of the uterus, which occur during traumatic childbirth, rough induced abortion, lead to the development of algomenorrhea.
6. Anomalies in the development of the genital organs. Rudimentary uterine horn with active endometrium, doubling of the uterus with hypoplasia of one of them, atresia cervical canal cervix leads to difficulty in the outflow of menstrual blood.

Clinic of dysmenorrhea

Primary algomenorrhea affects girls and women of asthenic physique, with reduced body weight, easily excitable and emotionally labile. Secondary dysmenorrhea is observed in women aged 30-40 years with a history of childbirth, abortion, gynecological diseases and surgical interventions, in IUD carriers and patients with long-term infertility. Clinical manifestations of algomenorrhea are divided into several groups:

1. Pain syndrome. Pain appears 1-1.5 years after the onset of menarche and coincides with the establishment of ovulatory cycles. In the first years of the disease, pain during menstruation is usually tolerable and does not affect performance. Over time, there may be an increase in pain, an increase in their duration, the appearance of new accompanying symptoms. Pain usually begins 12 hours before or on the first day of the menstrual cycle and continues for the first 2-42 hours or throughout the period. They have a cramping character, but can be aching, twitching, bursting, radiating to the rectum, the area of ​​​​the appendages, bladder, lumbar region, inner thighs.

2. Emotional and mental disorders: irritability, anorexia, bulimia, depression, drowsiness, odor intolerance, taste perversion.

3. Autonomic disorders: nausea, belching, hiccups, chilling, sensation of heat, sweating, hyperthermia, dry mouth, frequent urination tenesmus, bloating.

4. Vegetative-vascular manifestations: fainting, headache, dizziness, tachycardia, bradycardia, extrasystole, pain in the heart, coldness and numbness of the upper and lower extremities, swelling of the eyelids, face.

5. Metabolic and endocrine disorders: vomiting, feeling of "cotton" legs, general severe weakness, skin itching, joint pain, swelling, polyuria.
With secondary algomenorrhea, the symptoms listed above develop against the background of the clinical manifestations of the underlying disease.
There are compensated and decompensated forms of algomenorrhea. With a compensated form, the severity and character pathological process on the days of menstruation, they do not change over time, with a decompensated bath, the intensity of pain and violations of the general condition increase every year.

Diagnosis of algomenorrhea

Diagnostic measures are aimed at exclusion organic pathology genital organs, which can lead to the development of secondary algomenorrhea.

1. Anamnesis of life and illness
2. Objective examination
3. Gynecological examination
4. Ultrasound (to exclude adenomyosis, anomalies in the development of the uterus and vagina)
5. Hysteroscopy (with suspicion of internal endometriosis of the uterine body, submucosal myomatous nodes)
6. Laparoscopy in the premenstrual period (to exclude "small" forms of external endometriosis, varicose veins pelvic veins, wide ligament rupture)
7. Diagnostic curettage of the walls of the uterine cavity.

Treatment of algomenorrhea

I. Inhibition of prostaglandin synthesis during 3-4 menstrual cycles: rofecoxib (denebol, rofika) 12.5-25 mg 1 time / day, nimesulide (nimesil) 100 mg 2-3 times / day, naproxen 250 mg (1 tab.) 2-3 times / day, indomethacin 25 mg (1 tab.) 3 times / day, brufen 200 mg (1 tab.) 3 times / day, diclofenac one rectal suppository ( 0.01-0.05 g) at night, piroxicam 0.02 g orally or 1 rectal suppository (0.02 g) at night.

II. Analgesics and antispasmodics: analgin 2 ml of a 50% solution i / m, aspirin 200 mg 4-6 times / day, paracetamol 0.2-0.4 g 2-3 times / day, but-shpa 0 .04-0.08 g 3 times / day. or 2 ml of a 2% solution IM, baralgin 5 ml IM, spasmalgon 2 ml IM or 5 ml IV 2-3 times a day. Take 3-5 days before your period, during your period and 3-5 days after.

III. Beta-adrenergic agonists, for example, terbutaline 2.5-5 mg (table 1-2) 3 times / day.

IV. Vitamins: Unicap-T, Multitabs, Decamevit.

V. Tranquilizers: tazepam 0.01 g 1-3 times / day, frenol 2.5 mg 1-2 times / day.

VI. Hormone therapy:

1. Oral contraceptives: low-dose COCs (lo-gest, femoden, janine) according to the contraceptive regimen for 6-9 months.
2. "Pure" gestagens: dufaston 10 mg 2 times / day, morning-zhestan 100-200 mg 1-2 times / day. Appointed from the 5th to the 25th day of the cycle for 3-6 months.
3. Cyclic hormone therapy:

1st cycle: 4-6-8-10-12th days of the cycle - estrogens (folliculin 0.1% solution 1 ml, estradiol dipropionate 0.1% solution 1 ml, sinestrol 2% solution 1 ml, microfollin 0, 01 g, estriol 0.001 g) 1 time per day, intramuscularly or orally; 14-16-18th days of the cycle - estrogens (in the same doses) + gestagens (progesterone 1% solution 1 ml, utrozhestan 100 mg, dufaston 5 mg) 1 time per day, intramuscularly or orally; 20-25th days of the cycle - gestagens (in the same doses);
2-6th cycles: 10-12th days of the cycle - estrogens (in the same doses); 14-16-18th days of the cycle - estrogens (in the same doses) + gestagens (in the same doses); 21-22-23rd days of the cycle - gestagens (the dose is increased by 3 times);

VII. homeopathic remedies: remens 10-20 drops, diluted with water or in pure form 3 times/day 30 minutes before meals or 1 hour after meals, for a long time; klimadinon 30 cap. (1 tab.) 2 times / day, for a long time; femizol 1-2 tablets. 4-6 times a day in the premenstrual period.

VIII. Phytotherapy

IX. Physiotherapy:

Electrophoresis with novocaine on the area of ​​the carotid plexus No. 8-10 every other day;
- ultrasound with hydrocortisone ointment on the area of ​​the body of the uterus daily No. 3-5 in the premenstrual period.

X. Acupuncture

First, it is carried out throughout the entire cycle (1 course), then only in the second phase (2-3 courses).

Algodismenorrhea (in some sources, the pathology is called dysmenorrhea) is a disease that manifests itself with a whole range of symptoms - pain, impaired well-being, and nervous discomfort. More than half of the women different ages consult a doctor with similar complaints.

In some cases, the cause of this disease is anatomical features, and sometimes algomenorrhea itself is a sign of damage to the reproductive system.

According to international classification ICD pathology was assigned the code N94.4 - N94.6 (primary, secondary and dysmenorrhea of ​​unspecified origin).

What is it in simple words?

Algodysmenorrhea is a regularly recurring painful menstruation accompanied by metabolic, hormonal, neurological and psycho-emotional disorders. Menstrual pains are in the lead (8 - 80%) among the complaints of young women who turned to a specialist, but their presence is not always associated with gynecological pathology.

Reasons for the development of algomenorrhea

The menstrual cycle is formed with the participation of all the most important systems organism, so the cause of algomenorrhea can be located both in the uterus and appendages, and far beyond the genital organs.

Secondary algomenorrhea appears after a period of normal menstruation and is always associated with gynecological pathology. It occurs among the symptoms of external or internal endometriosis, infectious and inflammatory processes. pelvic region(endometritis, salpingoophoritis), submucosal (submucosal), endometrial polyps, adhesions and other ailments. They are the cause of menstrual pain. There are cases of algomenorrhea against the background of an intrauterine device.

Algodysmenorrhea in adolescents is of a primary nature, appears with the first menstruation with a "healthy" uterus and appendages. Its causes are conditionally classified into groups:

1. Hormonal: algomenorrhea often appears on the background hormonal dysfunction with insufficiency of the second (luteal) phase. The appearance of pain is due to the excessive influence of estrogens with an insufficient concentration of progesterone.
2. Endocrine: excessive contractions of the uterine muscles, eventually leading to its ischemia, are associated with a violation of the synthesis of prostaglandins - biologically active compounds that control contractility smooth muscles.
3. Neuropsychogenic: painful menstruation is more common in girls with labile psyche and low pain threshold.
4. Constitutional: with sexual infantilism, the uterus is hypoplastic, and its muscles are underdeveloped and poorly stretched due to the accumulation of menstrual blood.
5. Mechanical: menstrual pain may be associated with malformations of the genitals: partial or complete infection (atresia) of the cervical canal, wrong position uterus or its underdevelopment. The presence of anomalies in the development of the genitals leads to difficulty in the free flow of menstrual blood, it accumulates in the uterine cavity, stretches it and provokes pain.

It should be noted that the concept of pain during menstruation in different patients is not the same. It is determined by the individual pain threshold. If the examination of a patient with algomenorrhea does not reveal organic pathology, there are no concomitant systemic symptoms and progression of pain intensity, we can talk about physiological features pain perception.

Symptoms and first signs

Symptoms of such a disorder as primary algomenorrhea are not as pronounced as in secondary pathology. Therefore, the diagnosis of the disease in this case is difficult.

The main symptoms of secondary algomenorrhea depend on the cause of the development of the disorder in the patient. So, the most obvious symptoms with this violation are:

• , which occurs a few hours before the onset of menstruation and can last several days, and sometimes until the end of menstruation;
• copious menstrual flow;
• disorders of general well-being (headache, weakness, fatigue, sleep disturbance and lack of appetite).

In some cases, the symptoms are supplemented by an elevated body temperature, which can be increased slightly (low-grade fever) or to febrile levels. Also, the symptoms of algomenorrhea can be supplemented by symptoms of inflammatory or dystrophic processes in the pelvic organs:

• copious discharge from the vagina;
• pain during sexual contact;
• swelling of the labia and other symptoms.

Therefore, before prescribing treatment, the doctor must carefully examine the patient in order to exclude the possibility of her having other diseases that cause pain.

Diagnostics

The diagnosis is made on the basis of complaints, anamnesis and data additional research. The gynecologist finds out when the patient with algomenorrhea first experienced pain during menstruation, what is the duration of the pain, whether the pain is accompanied by a violation of the general condition, whether the patient with algodysmenorrhea suffers from gynecological diseases, whether there was a history of childbirth, abortion and operations on the female genital organs. During the survey, the doctor determines at what age menstruation began, what is the duration of the cycle, how often there are violations of the cycle and how heavy menstruation is.

After collecting complaints and clarifying the anamnesis, the specialist conducts gynecological examination, takes a smear from the cervical canal, vagina and urethra. Then a woman with algomenorrhea is sent for an examination, which includes ultrasound of the pelvic organs, general analyzes blood and urine tests, testing for sexually transmitted diseases and hormone levels. To clarify the ultrasound data, CT and MRI of the pelvis are used. With algomenorrhea, presumably caused by polyposis and endometriosis, hysteroscopy and separate diagnostic curettage. In some cases, laparoscopy is performed. If necessary, a patient with algomenorrhea is referred to a urologist, psychologist, psychotherapist and other specialists.

Treatment of algomenorrhea

At home, the approach to the treatment of primary and secondary algomenorrhea is unequal. To eliminate secondary algomenorrhea, it is necessary to cure the underlying disease, for the period of treatment, menstrual pain is relieved by painkillers.

Therapy of primary algomenorrhea implies the correction of all existing systemic disorders, therefore it is a lengthy process. There is no universal treatment regimen for all; for each patient, it is compiled individually according to the severity of pain and the nature of concomitant systemic manifestations.

For the treatment of primary algomenorrhea use:

1. Vitamins Unicap, Multitabs, Decamevit.
2. Antioxidants: Vitamin E in continuous mode for a long time.
3. Tranquilizers and sedatives: Tazepam, valerian tincture and others.
4. Analgesics and antispasmodics for direct action on the uterine muscles: No-shpa, Baralgin, Spazmalgon and analogues.
5. Preparations based on magnesium salts: Magne-B6 and analogues. Magnesium has been found to be involved in the transmission nerve impulse and the formation of the mechanism of muscle contractions, and with primary algomenorrhea there is a deficit.
6. Hormonal preparations. They are prescribed for girls with signs of hormonal dysfunction and insufficiency of the luteal phase of the cycle. Pre-conducted hormonal examination, and the menstrual cycle is adjusted according to its conclusion.
7. Non-steroidal anti-inflammatory drugs: Nimesil, Naproxen, Indomethacin, Ibuprofen, Aspirin and the like. They block the excessive synthesis of prostaglandins, thereby reducing the intensity of pain. With intense pain, it is advisable to prescribe these funds two days before the onset of menstruation in order to prevent severe pain.

If the amount of estrogen remains within the normal range, the lack of the luteal phase is compensated by gestagens. A severe degree of algomenorrhea against the background of an excess of estrogens requires the appointment of monophasic hormonal drugs: Logest, Lindinet, Janine and the like. The popularity of homeopathic therapy for primary dysmenorrhea is growing. In combination with drug treatment physiotherapy is also used.

Prevention

After making a diagnosis, the doctor explains to the patient what algomenorrhea is and gives recommendations to alleviate the symptoms of the disease. Yes, you should quit smoking. overconsumption sweets, carbonated drinks. When obese, you need to get rid of excess weight with the help of sports and the right diet. A few days before and during menstruation, it is advised to limit coffee. In the second phase of the cycle, preference should be given to vegetables, fruits, cereals, bran bread.

For normalization psychological state preparations containing magnesium and B vitamins (Neurovitan, Magnikum, Magne-B6) are needed. Doctors advise decoctions of lemon balm, motherwort, calamus root, yarrow herb for dysmenorrhea. Relieves pain mixture of bee royal jelly with honey. It must be kept in the mouth until completely dissolved.

For the treatment of secondary algomenorrhea great importance has a fight with her cause. And to eliminate pain during menstruation, anti-inflammatory and analgesic drugs are used. The prognosis depends on concomitant pathology. If it is treatable, then the symptoms of dysmenorrhea will also disappear over time.

Treatment prognosis

If the patient is diagnosed with a disease that belongs to the primary form of pathology, the prognosis of algomenorrhea is quite favorable. You just need to slightly adjust your lifestyle, nutrition and, if necessary, undergo a little therapy.

The situation with the treatment of secondary pathology is somewhat more complicated. If the patient turned to the local obstetrician-gynecologist in time, fully underwent examination and adequate treatment, then we can expect complete cure or at least reduce the intensity pain manifestations. Final result in this case, it significantly depends on the severity of the disease that causes such symptoms.

The main omen of a woman is the birth of a child. And if the symptoms described above begin to bother her, she should not be delayed with going to the doctor. Pain can talk about the development in the patient's body enough serious illness. There is only one conclusion. If a woman carefully fulfills all the requirements of her attending physician, then there are high chances of getting rid of such a disease as algomenorrhea once and for all, as well as fulfilling the mission given to her by nature - the birth of a new person.

The main thing is to contact a specialist in time and in any case do not give up, your health, first of all, is in your hands.

Mild discomfort during critical days is experienced by almost all representatives of the beautiful half of humanity. But some women are just stalked unbearable pain. Such malaise even sometimes makes it impossible to work. Painful monthly doctors call algomenorrhea. Why does discomfort occur? And what are the ways to get rid of it?

Description of the pathology: pain, scanty or profuse discharge

Algodysmenorrhea is one of the forms of menstrual irregularity.. It is characterized by severe pain during menstruation. Pathology is accompanied by excessively abundant or scanty discharge.

Algosdysmenorrhea occurs as a result of strong contractions of the uterus

This condition causes serious discomfort in a woman. In some cases, this is not a sign of pathologies of the genital organs, but most often signals the development of certain diseases.

Doctors, speaking of painful periods, use a few more terms, such as algomenorrhea, dysmenorrhea.

The mechanism of discomfort: what does the presence of blood clots indicate

Every month, the woman's body prepares for the conception of a child, at a certain period of the cycle, ovulation occurs (the release of a formed mature egg from the ovary). This process in some representatives of the fair half causes pain. They can last a few minutes or drag on for the entire period before the onset of menstruation.

Thus, pain before the onset of critical days may indicate successful ovulation.

The uterus is also preparing for the ability to endure a baby. In order to receive a fertilized egg into its bowels, the endometrium (the inner layer of the uterus) thickens under the influence of hormones. But if pregnancy has not occurred, then he begins to be rejected and comes out in the form of menstruation through the genital tract. This process is accompanied by uterine contractions, which cause characteristic pain.

The secretions are a complex mixture containing vaginal cells, blood, particles of the endometrium. Therefore, the presence of clots is normal. physiological phenomenon . But sometimes it can indicate serious violations in organism.

Classification of pathology

Doctors distinguish several degrees of algomenorrhea, depending on the severity of symptoms:

1. Easy degree. This form is characterized by moderate short-term discomfort. Pain does not disturb habitual way life and does not result in disability. The problem most often disappears after childbirth.
2. Average degree. A woman is tormented by a rather pronounced discomfort, weakness appears. Psycho-emotional disruptions join the malaise, which can be expressed by irritability, depression intolerance to sounds or smells. The performance is greatly reduced.
3. Severe degree. Pain is pronounced. The malaise may be accompanied by disturbances in the functioning of the heart, gastrointestinal tract, vegetative system. During menstruation, a woman completely loses her ability to work.

Primary dysmenorrhea occurs during adolescence

According to the mechanism of occurrence, dysmenorrhea is divided into:

1. Primary. Painful sensations appear during adolescence. Usually dysmenorrhea is observed in excitable girls who are characterized by emotional instability. Most often, primary algomenorrhea is not associated with pathologies. internal organs. Although such causes can be completely excluded only after examination.
2. Secondary. This pathology develops in adult women, as a rule, after 30 years. The occurrence of painful periods is dictated by acquired diseases of the genital area.

Primary dysmenorrhea is divided into 3 types:

1. Spasmodic. The appearance of pain provokes severe spasms of the uterus. The condition resembles in its manifestations "mini-birth".
2. Essential. This type pathology is associated with a low pain threshold in women.
3. Psychogenic. Usually girls with an unstable psyche suffer, anxiety states, fear of pain, a tendency to tantrums.

Why do painful periods occur in girls and women

Doctors believe that different factors underlie primary and secondary algomenorrhea.

Causes of primary dysmenorrhea in adolescence

Unpleasant discomfort appears in girls 6–18 months after the onset of menstruation. It is at this time that they set the process of ovulation..

The causes of primary algomenorrhea can be:

1. Hormonal changes. Phase 2 of the cycle is characterized by a deficiency of endorphin and enkephalin (happiness hormones). At the same time, the formation of prostaglandins increases. Such changes in the hormonal background cause pain.
2. Tuberculosis of the genital organs. Pathology, which has been developing since childhood, leads to various anomalies in the development of the genital organs. Menstruation may be absent or manifest as meager allocations accompanied by severe pain.
3. Developmental Disorders connective tissue which are often inherited. Anomalies can cause various pathologies: scoliosis, pelvic tilt, bowel problems. These changes provide negative impact on genital area(squeeze, lead to bending of the organs), as a result of which the girl experiences discomfort. In addition, with such disorders, magnesium deficiency is detected.
4. Diseases of the nervous system. Women suffering from psychosis, various neuroses, often have a heightened perception of pain.
5. Abnormal structure of the reproductive system. Underdevelopment of the uterus, kinks of the organ lead to severe pain during menstruation. The pathological structure worsens the outflow of blood from the cavity. The uterus is forced to contract more strongly. The result is severe pain.

Causes of secondary pathology: hysteroscopy with curettage, inflammation, IVF, removal of an ovarian cyst, Regulon cancellation, taking Duphaston, Postinor, Qlaira and other drugs

Painful discomfort in women can develop for the following reasons:

Symptoms accompanying algomenorrhea: pain, fever, depression and others

Dysmenorrhea, depending on the strength of manifestations, can provoke a whole "bouquet" of unpleasant symptoms:

Such signs in secondary algomenorrhea are complicated by symptoms gynecological pathology causing painful periods.

Diagnosis: what tests should be done

If there are unpleasant symptoms that seriously reduce the quality of life, the patient should go to the gynecologist for an appointment.

The examination begins with a questioning of the woman:

1. ABOUT clinical manifestations(when the discomfort appeared, what symptoms it accompanies, how long the discomfort lasts, where the pain is localized).
2. About the menstrual cycle (when menstruation began, how long it lasts, their abundance, regularity).
3. About gynecological diseases (whether there were previous diseases, whether there were surgical interventions).

Then the patient will undergo the following examinations:

Depending on the results of the tests carried out, consultations may be required. narrow specialists: endocrinologist, urologist, psychologist, surgeon, mammologist, psychiatrist.

Treatment Methods

For the treatment of algomenorrhea are used non-drug methods and drug therapy.

Non-drug methods include:

• dietary intake;
• psychotherapy;
• gymnastics, yoga;
• massage.

Drug therapy is prescribed individually, depending on the detected pathologies in the woman's body, characteristic symptoms and strength of manifestation of dysmenorrhea.

Diet food: essential vitamins and minerals

To help reduce pain:

1. Vegetable juices. They should be started a few days before the onset of menstruation. Very helpful beetroot juice, carrot, parsley drink.
2. Cellulose. It is advisable to introduce bran, rice (unpolished), vegetables into the diet.
3. Protein and iron. To replenish such substances, it is necessary to diversify the menu with liver, buckwheat.
4. Calcium, magnesium, potassium. These trace elements help to reduce the tone of the uterus, thereby reducing pain. To enrich the body with such minerals, nutrition should include:
   • string beans;
   • cottage cheese;
   • tomatoes;
   • yogurt;
   • green salad;
   • milk.
5. Vitamin E, especially in the first 3 days of menstruation. The supply of this substance will provide:
   • avocado;
   • corn;
   • olives;
   • beans.
6. Bananas. delicious product contains big number"happiness hormone" Therefore, with violations in the hormonal background, bananas can significantly reduce discomfort.
7. Ginger tea. It can be drunk with honey. Peppermint and chamomile teas also have analgesic properties.

Recommended products for the female body with dysmenorrhea - gallery

Wet juice is useful for dysmenorrhea
Unpolished rice will saturate the body with fiber
Beef liver provides iron and protein
Cottage cheese, milk will enrich the body with calcium, magnesium, potassium
Olives saturate the body with vitamin E
Banana is a real storehouse of the "hormone of happiness"
Ginger Tea Significantly Reduces Dysmenorrhea Pain

Massage

Helps to cope with unpleasant symptoms:

1. Acupressure. It is necessary to press for 1.5–2 minutes on a point located on inner surface knee.
2. Lumbar massage. You will need 2 small balls (for example, tennis). They are lowered into a regular sock or a bag of fabric so that they do not roll anywhere. On this "simulator" they lay down with their backs. The balls should be placed on both sides of the spine. It takes a few minutes to roll them with muscles.

During menstruation heavy loads contraindicated. They can increase bleeding in a woman. A hiking, simple gymnastics, yoga can bring significant relief.

Research scientists have confirmed that athletes are much less likely to suffer from algomenorrhea.

You can practice the following exercises:

Drug therapy: Aspirin, Papaverine, Magne B6 forte, Asparkam and other drugs

Medicines that can help a woman endure dysmenorrhea are prescribed by a doctor.

Usually therapy includes such groups of medicines:

1. Non-steroidal anti-inflammatory drugs. This is the main group of drugs used for algomenorrhea, which reduces pain, eliminates inflammation, and relieves swelling. Appoint:
   • Aspirin;
   • ibuprofen;
   • Paracetamol;
   • Naproxen;
   • Ortofen;
   • ibuprofen;
   • Diclofenac;
   • Voltaren;
   • Indomethacin.
     

     The following medicines perfectly block the growth of prostaglandin: Ketazon, Surgam, Sulindak, Reopirin, Piroxicam, Ketoprofen, Pirabutol, Nifluril, Butadion, Donalgin. They help to cope with pain and relieve heat Tsefekon (candles), Nise.

2. Antispasmodics. Sometimes recommend combined medicines, which not only eliminate pain, but also relieve muscle spasms. These medicines are:
   • Spazmalgon;
   • Maxigan;
   • Spazgin;
   • Trigan;
   • Minalgan.
     

     Some doctors advise combining NSAIDs with such antispasmodics: Platifillin, Papaverine, No-Shpa, Metacin, Sirdalud.

3. Antihistamines combined with sedatives. This combination is used for severe pain. The drugs are administered intravenously or intramuscularly. Dimedrol, Suprastin are used as antihistamines. From sedatives choose Sibazon, Relanium.
4. Combined contraceptives. These medicines can only be prescribed by a doctor, after weighing the condition of the woman and analyzing the contraindications. Benefits can bring:
   • Ovidon;
   • Norkolut;
   • Turinal;
   • Microgynon;
   • Marvelon;
   • Orgametril.
5. Vitamin complexes. To ensure the entry of minerals and vitamins into the body, the patient is prescribed:
   • Magne B6 forte;
   • Calcium D3 Nycomed;
   • Pentovit;
   • Neuromultivit.
   • vitamin E;

For adolescent girls, the most suitable medications are ibuprofen-based NSAIDs. For older women and menopausal women, hormonal therapy is most often recommended.

Medicines for algomenorrhea: tablets, suppositories - gallery

Magne B6 forte saturates the body essential magnesium
Papaverine relieves muscle spasms and pain
Asparkam replenishes magnesium and potassium deficiency in the body
Meloxicam is an excellent pain reliever and anti-inflammatory agent.
Sirdalud relieves spasms
Rigevidon is taken to normalize hormonal levels

Physiotherapy methods

Hardware physiotherapy is widely used to combat algomenorrhea. It is carried out on the eve of menstruation or in the second phase of the cycle.

1. Phonophoresis, electrophoresis using solutions: Novocain, Sodium bromide, Antipyrine, Trimecain.
2. Pulsed ultrasound on the lower abdomen.
3. Short-wave diathermy is an electrotherapeutic method based on the use of high-frequency alternating electric current.
4. Galvanized collar with nicotinic acid, bromine, calcium (according to Shcherbak A.V.).
5. DDT, SMT - impact impulse currents low frequencies.
6. Reflexology.

Folk remedies: what herbs are used

At menstrual pain Recipes of traditional healers will bring help:

1. Viburnum bark:
   • crushed raw materials (4 tsp) are poured with water (1 tbsp.);
   • the composition is boiled for half an hour;
   • filter;
   • add ordinary liquid to the liquid boiled water to get the initial volume;
   • take a decoction three times a day for 1 tsp. before eating.
2. Medicinal infusion:
   • combine lemon balm leaves and chamomile flowers in a ratio of 1: 1;
   • ready-made collection (1 tbsp.) Pour boiling water (1 tbsp.);
   • for half an hour, the remedy is insisted, then filtered;
   • take three times a day for 1-2 tbsp. l. before meals. It is necessary to start treatment a few days before the onset of menstruation, and finish - after it ends.
3. Medicinal teas. Drinks from raspberry leaves, chamomile flowers can reduce pain. Teas made from mint, catnip, strawberry leaves are useful. To relieve swelling, drinks from herbs with diuretic properties are recommended ( horsetail, bear ears).

Folk remedies for algomenorrhea - gallery

Melissa in combination with chamomile is used to prepare a medicinal infusion.
Horsetail has a diuretic effect

homeopathic treatment

Homeopathy provides excellent results. These drugs affect female body soft yet effective.

The following homeopathic remedies can be used:

1. Menonorm. It is recommended for admission with PMS (premenstrual syndrome), algomenorrhea, in menopause. Favorably affects the sexual sphere, strengthens the cardiovascular and nervous systems.
2. Basin. Used to reduce pain in dysmenorrhea. Often used in menopause.
3. Ginereg. The drug is intended for the treatment of inflammatory pathologies of the female genital organs, such as colpitis, endometritis, adnexitis.
4. Feminus. Used for menstrual irregularities chronic inflammation, during the menopause. The drug has a beneficial effect on the autonomic and central nervous systems.
5. Dysmenorm. It is prescribed for PMS, dysmenorrhea. The drug eliminates severe bleeding, regulates the cycle.
6. Klimadinon. The medicine is an effective replacement for hormonal medications. It is prescribed to eliminate psycho-emotional, vascular disorders in women during menopause, as well as before and after menopause.
7. Gynocoheel. The medicine is intended to improve the functioning of the female reproductive system. The drug has an anti-inflammatory effect. Therefore, it is often recommended for salpingitis, endometritis.

Prognosis and possible complications

The prognosis for algomenorrhea is quite favorable. Properly selected methods of treatment can normalize the condition. In most cases, there is complete relief from pain.

The prognosis of secondary dysmenorrhea depends on the disease underlying the development of menstrual pain.

Consequences: what can happen if the pathology is not treated

In the absence of adequate treatment, algomenorrhea can lead to negative complications of 2 types:

1. in the reproductive system. If the development of dysmenorrhea is based on gynecological diseases, then ignoring the pathology leads to its progression. Dealing with severe forms is much more difficult. Many gynecological diseases lead to infertility. And some of them can transform into oncology.
2. IN general well-being. Psychosomatic disorders can underlie the development of psychosis, depression. In addition, without appropriate therapy during menstruation, a woman's ability to work will decrease.

Preventive actions

1. Treat all inflammatory infectious diseases sexual sphere correctly and in a timely manner.
2. Observe personal hygiene.
3. Eliminate bad habits.
4. Stick to right image life ( good nutrition corresponding physical activity).
5. Visit a gynecologist.
6. With dysmenorrhea, follow all the recommendations prescribed by the doctor to eliminate discomfort.

Painful menstruation - video

Algodismenorrhea is an extremely unpleasant condition that can annoy a woman for years. Is it worth it to endure similar discomfort? Thanks to the rapid development of medicine, modern doctors have many tools in their arsenal that can help each patient cope with excruciating monthly discomfort.