menarche dysmenorrhea
Introduction
Introduction to menarche dysmenorrhea Dysmenorrhea refers to lower abdominal pain consistent with the menstrual cycle, the incidence rate is about 90%, about 50% to 60% of those who need analgesics, and only 10% of those who affect work and life. Girls with menarche for 1 to 3 years begin to have severe pain in the middle and lower abdomen around 12 hours before menstruation or menstrual period. In severe cases, they may affect the lumbosacral region and abdomen. They may be accompanied by nausea, vomiting, diarrhea or headache, fatigue and other symptoms. His face was pale, his limbs were cold, and he even collapsed. The pain lasted for 1 to 4 days. basic knowledge Sickness ratio: 5% Susceptible people: children Mode of infection: non-infectious Complications: Asthma
Cause
Causes of menarche dysmenorrhea
(1) Causes of the disease
Primary dysmenorrhea:
Pain is caused by the uterus itself, without pelvic lesions, common in the ovulatory menstrual period, so it occurs in 7 to 12 months of menarche, accounting for about 75%, such as ovulation at the beginning of menarche, then menarche begins at the menarche; Dysmenorrhea occurred in 13% in 2 years, 5% in the third year, and only 4% in the fourth year.
Secondary dysmenorrhea:
Adolescent girls are rare, caused by pelvic diseases, such as endometriosis, chronic pelvic inflammatory disease, pelvic congestion.
(two) pathogenesis
Primary dysmenorrhea:
1. Prostaglandin (PG) in the endometrium increases the concentration of estrogen and progesterone in the endometrium before menstruation, and promotes the synthesis of PG in the intima. When the membrane disintegrates during the period, PGE2 and PGF2a are released, causing strong uterine smooth muscle. Contraction, leading to increased intrauterine pressure, when intrauterine pressure exceeds arterial pressure (>26.7kPa, ie >200mmHg), uterine ischemia, pain symptoms similar to myocardial ischemia, because PGF2a and PGE2 also act on the trachea, The smooth muscles of the intestines and blood vessels can cause symptoms such as asthma, nausea, vomiting, diarrhea and elevated blood pressure.
2. Cervical canal stenosis or excessive uterine flexion causes obstruction of menstrual discharge, uterine contraction is enhanced, can cause dysmenorrhea.
3. Uterine dysplasia is often accompanied by abnormal vascular supply and ischemia, causing premenstrual and menstrual abdominal pain.
4. When the whole endometrium is discharged, it can cause strong uterine contraction and abdominal pain. It is also called membrane-like dysmenorrhea. The reason why the endometrium does not disintegrate is unknown. It is thought to be caused by excessive progesterone, and after progesterone is applied before menstruation. Can cause some membrane-like dysmenorrhea to disappear.
5. Other trauma, excessive fatigue, strenuous exercise, etc. can make dysmenorrhea worse.
Prevention
Menarche dysmenorrhea prevention
The law of life, prevention of overwork and trauma can reduce dysmenorrhea, prevent pelvic infections, reduce abortion surgery, and reduce the occurrence of secondary dysmenorrhea. Keeping warm is also a concern for patients with dysmenorrhea. In normal life, appropriate exercise is carried out to strengthen the physical condition and avoid the adverse effects of the stimulation of the cold.
Complication
Menarche dysmenorrhea complications Complications asthma
In severe cases, dysmenorrhea can cause collapse; asthma and elevated blood pressure can occur.
Symptom
Menarche dysmenorrhea symptoms common symptoms abdominal pain primary dysmenorrhea pale nausea fatigue fatigue secondary dysmenorrhea diarrhea
Primary dysmenorrhea
(1) 1 to 3 years of menarche (about 14 to 15 years old): The girl starts from the middle of the menstrual period about 12 hours before menstruation or the menstrual period. The severe pain can affect the lumbosacral region and abdomen, which may be accompanied by nausea and vomiting. , diarrhea or headache, fatigue and other symptoms, the heavy face pale, limbs cold, and even collapse, the pain lasts 1 to 4 days.
(2) Asymptomatic during non-menstrual period.
(3) Anal examination and/or pelvic B-ultrasound examination is normal.
2. Secondary dysmenorrhea
Unlike primary dysmenorrhea, abdominal pain occurs more than a few years after adulthood. It is more common in adult women. The pain is characterized by increased menstruation, discomfort during non-menstrual periods, poor morphine analgesics, pelvic examination and/or pelvic ultrasound. Check for lesions.
Menstrual seizures, abdominal pain disappeared after the passage and normal pelvic examination can be diagnosed as dysmenorrhea, but attention should be paid to secondary dysmenorrhea caused by organic diseases, and sometimes both dysmenorrhea occur simultaneously.
Examine
Menarche dysmenorrhea
General laboratory tests are normal.
Abdominal B-ultrasound should be performed to understand the size of the uterus and whether there is any abnormality.
Diagnosis
Diagnosis of menarche dysmenorrhea
The following diseases that occur during the menstrual period can cause abdominal pain and need to be identified:
1. Ovarian tumor pedicle torsion can be found in different sizes of tumors, the symptoms are mostly limited to the disease side.
2. Ovarian corpus callosum rupture abdominal pain is often accompanied by nausea and convenience, the symptoms are biased to one side.
3. Appendicitis metastatic abdominal pain and one side of the body is heavier.
