- Symptoms of Algodismenorei
- Reasons of Algodismenorei
- Treatment of Algodismenorei
The pains at periods arising owing to infantility, the wrong position of a uterus, inflammatory processes in generative organs at endometriosis and other diseases, and also at a hyperexcitability of TsNS. It is observed usually at young women (often at infertility). Pain develops some days before periods, often happens very strong and is followed by a headache, nausea, vomiting and dizziness. From the beginning of periods it passes in itself.
Symptoms of Algodismenorei:
Colicy pains in days of periods or some days before it are localized in the bottom of a stomach, irradiate to the lumbar area, is more rare to the area of outside genitalias, a groin and hips. Pains pristupoobrazny and quite intensive, are followed by the general weakness, nausea, vomiting, a spastic headache, dizziness, temperature increase to 37ºС, dryness in a mouth, abdominal distention, faints and other frustration. Sometimes one symptom which disturbs more, than pain becomes the leader. Severe pains exhaust a nervous system, promote development of an asthenic state, reduce working capacity.
Reasons of Algodismenorei:
Any disease as, for example, fibroma, endometriosis and others happens the reason of severe pains at monthly. At the same time national methods of treatment not always work, it is necessary to address the experienced specialist, that is the doctor who will be able precisely to define at you why severe pain at monthly.
Shortage of an exercise stress happens the second reason of painful periods sometimes.
Treatment of Algodismenorei:
Treatment of an algodismenorea consists in elimination of the reasons generating it. For easing of pains analgetics and tranquilizers are used.
The main method of treatment is use of the inhibitors of synthesis of a prostaglandinsintetaza called still by non-steroidal anti-inflammatory drugs. Treat their number: acetylsalicylic acid (aspirin) in a dose of 0,25-0,75 3–4 times a day after food, paracetamol — on 0,5–1,0 g 2–4 times a day, an ibuprofen (Brufenum) on 0,2–0,4 g 3–4 times a day after food, Naproxenum (Naprosinum) — on 0,25–0,5 g 3–4 times a day after food, diclofenac (Ortophenum, Voltarenum, a revodina) — on 0,025–0,05 g 2 - 3 times a day after food, indometacin (metindol) — in the same doses or rektalno in the form of candles. Such drugs as кетазон, to surga, piroxicam, ketoprofen, сулиндак, mefenaminovy acid, Rheopyrinum, Pyrabutolum, Butadionum, доналгин, niflurit, etc. in the corresponding doses are successfully used. The main principle of treatment by inhibitors of synthesis of prostaglandin is preliminary (precautionary) reception of medicines in 2–4 days prior to the beginning of periods (emergence of pains) and during the next 2–4 days. In this case menstrual pains if develop, then against the background of the carried-out treatment are expressed much more weakly and are easier transferred by patients. Use of the combined renalgan drugs (Baralginum, триган, максиган, минальган, спазгин, спазмальгин, спазмальгон, веральгин) containing in the structure except analginum in rather high dose (0,5 in a tablet, 2,5 in an ampoule of 5 ml) two effective spasmolysants is very useful. These drugs are appointed on 1–2 tablets 2–3 times a day (irrespective of meal) according to the stated above scheme beforehand, and at insufficient effect or very severe menstrual pains ("menstrual colic") can be entered intramusculary or intravenously in a dose of 2-5 ml, slowly within 3 - 5 minutes, sometimes into mixes with antihistaminic (Dimedrol of 1% — 1–2 ml, Chloropyraminum (Suprastinum) of 2% — 1 ml) and sedative (Relanium, Sibazonum of 0,5% — 2 ml) drugs. Usually treatment is carried out during 3-4 menstrual cycles. At inefficiency or insufficient efficiency COC (the combined oral contraceptives) are applied to treatment of both types of an algodismenorea in the absence of contraindications.
Drugs with high content of a gestagenny component (овидон, Rigevidonum, микрогинон, марвелон) which apply according to the contraceptive scheme within 21 days, since 1 (5th) day of a menstrual cycle are most effective. Purpose of "pure" gestagen is rather effective: Norcolutum (Norethisteronum), turinal, ацетомепрегенол, orgametrit, дуфастон (дидрогестерон) — 5–15 mg a day from the 14-16th to the 25th day of a menstrual cycle. Earlier intramuscular administration of progesterone of 1% — on 2–3 ml daily or every other day on the eve of periods — 4–6 injections was applied. The way of treatment by desensitization is offered E. M. Govorukhina by hormones which consists in intradermal introduction in 8–10 days prior to periods of 0,1 ml of oestradiol of Dipropionas of 0,1% and the same dose of 1% of solution of progesterone to the area of an internal surface of a forearm at distance of 3 cm from the first injection. In total 3 such courses are conducted. By data I. L. Luzina and L. P. Bakuleva, the good therapeutic effect at primary algodismenorea gives use of a-tokoferolaatsetata (vitamin E) in a dose of 300 mg a day in the first three days of painful periods.
At insufficient efficiency of inhibitors of prostaglandin it is reasonable to combine them with spasmolysants (a papaverine, Platyphyllinum, Methacinum, atropine, Nospanum, Halidorum, бускопан). Sublingual use of antagonists of calcium is rather effective: nifedipine (Corinfarum, кордафен, Adalatum), Phenihydinum on 10–30 mg once — recommended by the Italian and French authors. In certain cases use in ergot alkaloids — 0,1% of solution of ergotamine of hydrotartrate or dihydroergotamine (dihydroergotoxin) — drops is useful till 10-20.
Practically in all cases of an algodismenorea it is necessary to warn against use of narcotic analgetics resolutely.
Broad application is found by the hardware physical therapy which is carried out to the second phase of a menstrual cycle or on the eve of periods: an electrophoresis and фонофорез solutions of novocaine, Trimecainum, magnesium sulfate, antipyrine, sodium bromide on a bottom of a stomach and area of an abdominal brain, a galvanic collar according to A. V. Shcherbak with calcium, bromine, niacin, ultrasound on a stomach bottom in pulsed operation, impulse currents of the low frequency (DDT,SMT), a short-wave diathermy, the central electroanalgesia etc.