What are the causes of dysmenorrhea?

Dysmenorrhea may be caused by primary dysmenorrhea, endometriosis, adenomyosis, pelvic inflammatory disease, uterine fibroids, etc. Dysmenorrhea usually manifests as cramping pain in the lower abdomen, which may be accompanied by symptoms such as nausea and backache.

1. Primary dysmenorrhea

Primary dysmenorrhea is related to excessive secretion of prostaglandins and is more common in young women. It occurs within 1-2 years after menarche. The pain usually starts before menstruation and lasts for 2-3 days. It can be relieved by hot compress. If necessary, use ibuprofen sustained-release capsules, acetaminophen tablets or naproxen sodium tablets as directed by your doctor.

2. Endometriosis

Endometriosis may cause increased pelvic pain during menstruation, which may radiate to the lumbosacral region. The disease is associated with reflux of menstrual blood and may lead to infertility. Diagnosis needs to be combined with ultrasound examination, and drugs such as dienogest tablets, medroxyprogesterone acetate dispersible tablets, or goserelin sustained-release implants can be used for treatment.

3. Adenomyosis

Adenomyosis presents with progressively worsening dysmenorrhea, accompanied by increased menstrual flow. Ultrasound examination showed uniform enlargement of the uterus. In mild cases, tranexamic acid tablets can be taken to control bleeding, but in moderate to severe cases, levonorgestrel intrauterine sustained-release system or hysterectomy may be required.

4. Pelvic inflammatory disease

Dysmenorrhea caused by pelvic inflammatory disease is mostly secondary, accompanied by abnormal leucorrhea and dyspareunia. Pathogen infection is the main cause, and antibiotics such as ceftriaxone sodium injection, metronidazole sodium chloride injection, or doxycycline enteric-coated capsules need to be treated in a standardized manner.

5. Uterine fibroids

Submucosal uterine fibroids may cause prolonged menstrual periods and worsened dysmenorrhea, and ultrasound examination can confirm the diagnosis. Small fibroids can be observed, and those with obvious symptoms can use mifepristone tablets to shrink the fibroids. If necessary, myomectomy or hysterectomy can be performed.

Patients with dysmenorrhea should keep warm during menstruation and avoid strenuous exercise and cold and raw foods. You can drink ginger tea or hot milk every day, and use a hot water bottle to apply heat to your lower abdomen. If the pain continues to worsen or is accompanied by abnormal bleeding, you should seek medical treatment promptly to check for organic diseases. Maintaining a regular schedule and moderate exercise can help improve pelvic blood circulation and reduce menstrual discomfort.