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Dysmenorrhea (algodysmenorrhea) is a menstrual disorder characterized by pain during menstruation. According to statistics, more than half of women of reproductive age complain of painful menstruation. In order to avoid dangerous complications, it is very important to diagnose the pathology in a timely manner and undergo a course of treatment.
We are talking about dysmenorrhea only if the pain syndrome is severe enough. According to various sources, approximately every tenth woman experiences significant pain that is cyclical in nature and associated with menstruation. Moreover, in many cases, patients note not only pain, but also a noticeable deterioration in their general condition, decreased performance, changes in psycho-emotional state, and forced abandonment of the usual rhythm of life.
1.General information
“Algomenorrhea” literally means a disturbed, irregular menstrual cycle in mandatory combination with pain syndrome (“algo-”). Thus, this term differs from the narrower ones: “dysmenorrhea” (cycle irregularity); “algomenorrhea” or “menalgia” (painful menstruation).
However, even without terminological nuances it is obvious: algodismenorrhea is a complaint that is heard in the gynecologist’s office much more often than any other.
Epidemiological estimates, including for Russia, vary widely. The most commonly reported (or repeated from sources from the 1990s) prevalence of algomenorrhea is 40-55% among women aged from menarche to 45 years. However, in a number of publications, the incidence of “painful menstrual syndrome” is estimated much more pessimistically - up to 80% or, conversely, more optimistic - 8-10% (which seems to be clearly underestimated).
Meanwhile, the medical and social significance of the problem is undeniable. Algomenorrhea sharply reduces a woman’s quality of life, limiting her social functioning and negatively affecting her psychological state. When severe, this symptom complex leads to temporary disability. Finally, algodismenorrhea is often the only sign of latent gynecological pathology, which, even being severe and dangerous, does not manifest itself in anything else until a certain moment.
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HOW TO MAKE CRITICAL DAYS EASIER
Menstruation is a monthly process in a woman’s body when a fairly strong hormonal imbalance occurs.
This is a very painful process that entails rapid and unexpected mood swings, unpleasant physical pain and irritability. In fact, you can help yourself without exposing yourself to unpleasant sensations.
A decoction of raspberry leaves has beneficial properties. It will ease bleeding and help withstand blood loss.
Raspberry leaves are rich in minerals, vitamins and rare alkaloids, which regulate the body's metabolism and muscle tone.
A special pillow will improve the quality of your sleep, it will help relax the muscles of the neck and shoulders, and will reduce pain in this area, which is typical during critical days. Primrose oil or coconut oil is guaranteed to help get rid of cramps and cramps. You need to take them constantly or a week before your period.
During menstruation, you need to follow proper nutrition, since salty, fatty and sweet foods only worsen your well-being. It is also better to include foods containing vitamins A, B6, C and an increased amount of complex carbohydrates in your diet.
If possible, red foods, coffee and chocolate should be excluded from the diet. If cystic acne occurs, you need to introduce foods containing calcium, beets, carrots, cabbage, garlic and artichokes into your diet. Try not to be nervous on critical days, treat yourself to something pleasant, for example, a new purchase or a surprise. Take more walks in the fresh air.
The use of tampons very often leads to pain and cramping, so it is better to use sanitary pads.
One of the excellent methods of getting rid of physical discomfort during menstruation is yoga (for those who do it), or relaxation, or light exercise. First, take a bath, relax and do some exercises.
Cobra pose, bridge or fetal pose are most suitable to engage the pelvic and abdominal muscles and relieve muscle tone, in turn, exercises have a positive effect on a woman’s body during menstruation. As you know, during physical exercise the body releases the hormone endorphin, and it acts as a kind of analgesic.
The uterus is a muscle that, when contracted, causes pain; Try doing a deep pelvic massage by placing a rolled towel under your lower back, this will help relieve pain. And, of course, taking herbs will ease your condition.
Keep in mind that if you experience very severe pain during your period, this may be due to serious gynecological diseases, in which case consult a doctor.
2. Reasons
Primary and secondary algodismenorrhea are two fundamentally different forms of the syndrome.
Primary, or functional, is characterized by the absence of pathological changes in the genitourinary system that could be objectified by existing diagnostic methods. In other words, it hurts where there seems to be nothing to hurt, since all organs and structures are anatomically correct, intact (not damaged), functionally sound and not affected by any pathological process. Various hypotheses in this regard are currently being put forward and discussed. Thus, one cannot ignore the role of the psychological factor: primary algodysmenorrhea usually affects nulliparous young women or young girls, especially those of asthenic physique, with certain features of psychophysical infantilism, neurasthenic or labile-hysteroidal personal constitution. These features create the preconditions for anxiety-neurotic disorders associated with anticipation of the onset of menstruation, corresponding discomfort or further pain, if painful menstruation has already been experienced. Sometimes primary algodismenorrhea is noted already at menarche or shortly after the start of the menstrual cycle. A psychogenic decrease in the pain threshold, according to this hypothesis, leads to the fact that any physiological sensations associated with a neurotic dominant, to which normally the brain simply “does not pay attention,” are perceived in advance as painful in disorders of this kind.
Without detracting from the significance of the psychogenic factor, supporters of the biochemical hypothesis see the main cause of primary algodismenorrhea in the abnormal, excessive production of prostaglandins - biologically active substances that regulate many processes (including changes in the muscle tone of the uterus, the “behavior” of blood vessels, inflammatory responses, the intensity of pain, and many others). .). If they are in excess, transient spasms and ischemic phenomena may occur, i.e. deficiency of blood supply to the uterine endometrium. Just as the brain is notified of ischemia or myocardial infarction by an intense pain signal, menalgia can be caused in a similar way. This interpretation is currently recognized by most experts and is satisfactorily confirmed by clinical practice.
As for secondary algodismenorrhea, it is always a consequence of one or another organic pathology.
The most common cause is endometriosis, but painful menstruation can also be caused by urogenital infections or inflammation of a different nature, benign and malignant neoplasms, adhesions, etc.
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Algodismenorrhea classification ICD-10
N94.0 - Pain in the middle of the menstrual cycleN94.1 — Dyspareunia (Excludes: psychogenic dyspareunia (F52.6)N94.2 — Vaginismus (Excludes: psychogenic vaginismus (F52.5)N94.3 — Premenstrual tension syndromeN94.4 — Primary dysmenorrheaN94.5 — Secondary dysmenorrheaN94.6 — Dysmenorrhea, unspecifiedN94.8 — Other specified conditions related to the female genital organs and the menstrual cycleN94.9 — Conditions related to the female genital organs and the menstrual cycle, unspecified3. Symptoms and diagnosis
By definition, the leading and obligate (mandatory for diagnosis) symptom is pain accompanying the period of menstruation or occurring immediately before it. The severity of pain can be so great that a woman literally falls out of her usual way of life for several days, losing her ability to work and the ability to carry out any active activity. Many patients experience irradiation of pain in the back, legs, groin and other areas. In addition, the etiology of algodismenorrhea determines the presence of additional symptoms in various combinations: weakness, headache, flatulence, dyspepsia, dysuria, general malaise with fever, dry mouth, syncope, etc.
The primary task in diagnosing algodismenorrhea is to identify or confirm organic pathology.
In other words, first of all it is necessary to establish whether the pain syndrome is primary (psychogenic or hormonally caused), or whether it is just the tip of a pathological iceberg, otherwise progressing latently. For the purpose of differential diagnosis, the anamnesis is carefully studied, the nature of the complaints, the mental and somatic characteristics of the patient, her age, social and reproductive status are analyzed. A thorough laboratory and instrumental examination is prescribed (the choice of methods today is very wide and is determined by the gynecologist, based on specific indications and the most likely clinical assumptions). Only after background gynecological diseases and endocrine disorders have been conclusively excluded can we say that algodismenorrhea is of a primary (functional, essential) nature.
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Algomenorrhea, painful menstruation: traditional medicine recipes, recommendations
More often observed in young women. Pain appears 1-2 days before the onset of menstruation and continues for the first 2 days. They can occur with inflammatory diseases of the genital organs, as well as with increased excitability of the nervous system. There may be neuropathological reasons. For example, endocrine imbalance can cause a sharp constriction of blood vessels in muscle tissue or in the mucous membrane. Symptomatically manifested in the form of pain in the lower abdomen, headache, dizziness, nausea, vomiting.
In these cases, you can use the technique of oriental massage.
Lie on your back or sit, leaning against the wall, stroke, then massage the abdominal wall from top to bottom (from the lower part of the Georgian to the lower part of the abdomen), gradually increasing the pressure until using the “drawing” massage technique only 15-20 times.
Then proceed to kneading (mainly the lower abdomen) - 15-20 times. This is followed by applying pressure with rotation in the same area - 15-20 times. Having finished treating the abdomen, you should move on to the back area.
The back massage also begins with stroking from top to bottom, from the area 10 centimeters above the lower back to the tailbone. Stroking turns into rubbing, kneading, pressing with rotation. A total of 20-30 times. This is followed by light tapping and chopping.
✅ Linear massage must be combined with acupressure.
✅ Infusion or decoction helps in these cases (5 min.) 1 tsp. chopped lovage roots. Take 1 tbsp. 3 times a day before meals.
✅ Celery juice has an analgesic effect for menstrual pain, take ½ glass in 2 doses.
✅ Common wormwood (Chernobyl) is used as an infusion of 1 tbsp. per glass of boiling water, heat for 30 minutes. take ½ glass 2 times a day.
✅ Infusion 2 tbsp. red clover in 1 tbsp. boiling water for 6 hours, covered, drink 3-4 doses before meals.
✅ For painful periods, it is useful to drink cumin tea: 1 tsp. Pour a glass of boiling water over cumin seeds and leave for 10 minutes. Drink a glass in small sips 2-3 times a day.
4.Treatment
It should be noted, in continuation of the comparative analysis of the primary and secondary forms, that there is still an idea that algodismenorrhea is something like a “growing disease” that occurs all the time, does not require treatment and disappears without a trace after marriage and first birth. This is not only wrong, but often the exact opposite of what actually happens. It is with the onset of regular sexual activity, with the onset of pregnancy, during the gestation period that latent pathology of the reproductive system can manifest itself, the harbinger or only symptom of which was previously “ordinary” menstrual pain. No pain syndrome should accompany critical days - for the female body this is a completely normal physiological process, and it should not turn into a painful disease with a cyclical course. Therefore, the very complaint that many patients perceive as something inherent in almost any woman, insignificant and not worthy of mention in a conversation with a doctor - painful menstruation - is in fact a clear reason for contacting a gynecologist, even if there are no other complaints or violations.
Based on the results of the examination (see above), one or another treatment regimen is prescribed; It is obvious that these schemes are too individual and diverse (depending on the form and specific etiology of algodismenorrhea) to be described in detail or even listed. Let us only note that the most effective is an integrated approach, including, first of all, treatment of the underlying disease (if it is identified, i.e. in the secondary form of algomenorrhea), prostaglandin inhibitors (nonsteroidal anti-inflammatory drugs, NSAIDs), according to indications - painkillers, antispasmodics, sedatives, vitamin complexes, physiotherapeutic procedures.
Attention is necessarily paid to the normalization of lifestyle and psychological microclimate; with primary algodismenorrhea, a special course of psychocorrection is often also necessary.
Pathogenesis
Regardless of the etiology, the pathogenetic process is based on excessive synthesis of prostaglandins (PGs).
It is also worth considering that PGs increase the sensitivity of nerve fibers, which is caused by an increase in pressure in the uterine cavity with excessive contractility of the myometrium.
Due to a sharp increase in the production of PGs (primarily E2a and E2), they accumulate in the endometrium and cause platelet aggregation, vasoconstriction, irregular contractions of myometrial fibers and lead to the development of endometrial ischemia.
Thus, the mechanism of pain during algodismenorrhea is correlated with the processes during acute myocardial ischemia - arterial spasm and bleeding of muscle tissue.
The synthesis of PG is controlled by cyclooxygenase (COX), the activity of which, in turn, is regulated by sex hormones - estrogens and progesterone.
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Gynecologists at our clinic
Gaponova Natalia Mikhailovna
Obstetrician-gynecologist, ultrasound diagnostics doctor
Main areas of practical activity: treatment of infectious and inflammatory diseases of the pelvic organs, ovarian dysfunction, menstrual irregularities, correction of menopausal disorders, minimally invasive treatment methods in gynecology, intimate surgery. Pregnancy management, female infertility.
Kulik Svetlana Vladimirovna
Obstetrician-gynecologist, ultrasound diagnostics doctor
In 2000, she graduated from the medical faculty of the Volgograd Medical Academy. Has additional professional retraining in gynecology-endocrinology, operative hysteroscopy, ultrasound diagnostics in obstetrics and gynecology.
Work experience in the specialty is 12 years.
Ivanova Natalya Vladimirovna
Obstetrician-gynecologist, doctor of the highest category, candidate of medical sciences
In 1983 she graduated from Voronezh State Medical Institute named after. N.N. Burdenko. Areas of professional interests: recurrent miscarriage, plastic surgery of the labia minora and majora, vaginal restoration after traumatic childbirth.
32 years of experience in the specialty.
Kavun Irina Sergeevna
Obstetrician-gynecologist, ultrasound diagnostics doctor
In 1987 she graduated from the medical faculty of the Yaroslavl State Medical Institute. Doctor of the highest category. Has professional retraining in ultrasound diagnostics in obstetrics and gynecology, surgical obstetrics and gynecology, endoscopy.
Work experience in the specialty is 25 years.
Smirnova Lyudmila Evgenievna
Obstetrician-gynecologist. Candidate of Medical Sciences. Doctor of the highest category.
Engaged in the diagnosis and treatment of diseases of the female reproductive system and pregnancy management. He is engaged in scientific work.
Work experience 16 years.
Buga Marina Vladimirovna
Obstetrician-gynecologist, ultrasound diagnostics doctor
In 1987 she graduated from the medical faculty of the Kazan State Medical Institute. Has retraining in gynecology-endocrinology, ultrasound diagnostics in obstetrics and gynecology. Specializes in the treatment of diseases of the female reproductive system.
Work experience in the specialty is 25 years.
Frequently asked questions about algodismenorrhea
Who is more likely to experience algomenorrhea?
The exact causes of the disease cannot be established, but it has been noted that algomenorrhea more often occurs in women with luteal phase deficiency, hyperestrogenism, nervous system lability, uterine malformations, endometriosis, intrauterine device, and hormonal disorders.
Is it possible to treat algodismenorrhea yourself?
The disease can occur for various reasons, so it cannot be cured on its own. It is worth seeing a doctor and undergoing a full examination. Only in this case will the treatment be effective.
Which painkillers are best?
To relieve pain in algodismenorrhea, non-steroidal anti-inflammatory drugs are used: acetylsalicylic acid, nimesulide, indomethacin, meloxicam, diclofenac. In some cases, taking antispasmodics is sufficient.
