Dysmenorrhea

Dysmenorrhea – the pathological process which is characterized by the severe pains during periods which are absent throughout other cycle. Distinguish two types of disturbances: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is diagnosed in cases when the reasons of painful periods are not established. The dysmenorrhea develops at 45-60% of women of childbearing age. For the first time the dysmenorrhea can be shown in the first ovulatory menstrual cycle, significantly reducing the level of vital activity and efficiency of the woman. The dysmenorrhea meets at the women of an asthenic constitution inclined to a loss of consciousness, irritable more often. The disease is also characteristic of patients with vegeto-vascular dystonia and an asthenoneurotic syndrome.

Primary dysmenorrhea

Primary dysmenorrhea – the functional disturbance of a menstrual cycle which is not caused by pathological processes in bodies of a small pelvis. Primary dysmenorrhea develops at youthful age and can be shown both during the first menstrual cycle, and 1-3 years later after the beginning of periods. As a rule, pains at such dysmenorrhea are tolerant, with age painful feelings can amplify. According to character and expressiveness of pains at primary dysmenorrhea allocate two forms: the compensated and noncompensated dysmenorrhea.

The compensated dysmenorrhea is characterized by an invariance of painful feelings eventually whereas the noncompensated dysmenorrhea is characterized by the amplifying pains eventually. As a rule, at the second form of a dysmenorrhea of the patient cannot do without the qualified medical care.

Pain at a dysmenorrhea can develop in 1-2 days prior to estimated periods, and also remain for the first days of a menstrual cycle. In most cases at a dysmenorrhea of pain have the skhvatkoobrazny, aching, pulling character. The pains of arching character irradiating in a rectum, area of a bladder, appendages are in rare instances observed.

Secondary dysmenorrhea

Secondary dysmenorrhea – the pathological process caused by disturbances of functioning of bodies of a small pelvis, inflammatory processes, gynecologic diseases. The secondary dysmenorrhea is, as a rule, diagnosed for patients after 30 years. The secondary dysmenorrhea meets in 27-33% of cases of total number of the diagnosed diseases, has more difficult character. At a secondary dysmenorrhea the period of loss of efficiency of the patient considerably increases. Painful feelings begin approximately a day before estimated periods. This type of a dysmenorrhea is characterized by plentiful menstrual bleeding with existence of a large number of clots, severe pains in a waist.

Dysmenorrhea: causes of illness

At primary dysmenorrhea of the reason of development of disturbance can be both physiological, and psychological character. At a dysmenorrhea development of the PGE2 (E2 prostaglandin) and the PGE2-alpha (E2 alpha prostaglandin) promoting reduction of smooth muscles and strengthening painful feelings can be the cause of painful feelings. At primary form of a dysmenorrhea of the reason can be covered in disturbance of a hormonal background.

The psychological reason of development and strengthening of painful feelings at a dysmenorrhea during periods is the fear of the patient of pain. So, anticipation of pain aggravates her perception.

At a secondary form of a dysmenorrhea causes of infringement can become:

• Expansion of pelvic veins;
• Inflammatory diseases of bodies of a small pelvis;
• Tumors of bodies of a small pelvis;
• Commissural processes after an operative measure;
• Endometriosis;
• Dysplasia;
• Hormonal disturbances in an organism;
• Intrauterine spiral;
• Diseases, sexually transmitted.

Dysmenorrhea: disturbance symptoms

Each of forms of a dysmenorrhea is characterized by a complex of symptoms according to which the diagnosis is made. At primary form of a dysmenorrhea symptoms are shown as follows:

• Pains of various character;
• Nausea, vomiting, dizziness, general weakness;
• Fervescence;
• Red spots on skin of hands, necks, persons;
• Locks;
• Disturbance of cordial rhythms;
• Sleep disorders, sleeplessness.

These symptoms of a dysmenorrhea are caused by increase in level of hormones of adrenaline, dopamine, noradrenaline and define adrenergic type of a dysmenorrhea.

Also at a dysmenorrhea symptoms can be caused by increase in level of hormone of serotonin that brings to:

• To heartbeat reduction in the frequency;
• To vomiting, diarrhea;
• To fall of temperature of a body.

These symptoms define parasympathetic type of a dysmenorrhea.

At a secondary dysmenorrhea symptoms can be added with symptomatology of the basic disease which is the reason of painful monthly.

In certain cases at a dysmenorrhea a symptom is painful sexual intercourse.

Diagnosis of a dysmenorrhea

The main diagnostic methods of a dysmenorrhea are the clinical picture and complaints of the patient to characteristic painful feelings. Also for an exception of the possible reasons of development of a dysmenorrhea ultrasonography of bodies of a small pelvis, a smear, the analysis of the hormonal status, hysteroscopy (survey of walls of a uterus by means of the special device, allows to reveal any intrauterine deviations, it is carried out in the conditions of a hospital), a laparoscopy is carried out (survey of abdominal organs by means of the special device, surgical intervention which is carried out in the conditions of a hospital).

Dysmenorrhea: treatment of a disease

At a dysmenorrhea treatment can be conservative (medicamentous drugs) and radical (surgical methods) character. At a dysmenorrhea treatment by conservative methods aims at stopping of pains, and also elimination of their reasons. The symptomatic treatment of a dysmenorrhea is in certain cases applied.

Distinguish three types of drug treatment of a dysmenorrhea:

• Gestagena – group of the hormones promoting updating of the tissues of mucous membrane of a uterus relaxing muscles of a uterus, regulating formation of estrogen;
• Hormonal contraceptives – in most cases at a dysmenorrhea are applied the combined oral contraceptives suppressing an ovulation and promoting reduction of production of prostaglandins. As a result intrauterine pressure decreases, amplitude and frequency of reductions of muscles of a uterus decreases that promotes elimination of pain;
• Non-steroidal anti-inflammatory drugs – are appointed to patients to whom for certain reasons gestagena and hormonal therapy are contraindicated. At a dysmenorrhea treatment by this type of drugs is temporary (only during periods), unlike OK and gestagen which are accepted on a constant basis.

Surgical methods are applied only at acute endometriosis, inflammatory processes of generative organs, defects of a structure of generative organs (the narrow channel of a neck of uterus).