A significant proportion of women may develop soreness, and changes in the general well-being associated with the first day of the cycle. Painful symptoms experienced by some estimates 80% of women, while in 12% of cases, pain is pronounced, resulting in temporary disability. Top of the menstrual cycle is accompanied by a set of autonomic, emotional disturbances, which became known as dysmenorrhea or algodismenorei.

The social significance of the problem

Most women experience some kind of fear before the next menstruation. This is due to the expectation expressed in the development of pain and a change in general well-being, which is observed during the first days of the start of menstrual bleeding and gradually passes to the moment it ends. For dysmenorrhea clinical picture characterized by the following symptoms:

• Clinic pain predominates. Pain often cramping paroxysmal character, less whining and Expander. The degree of pain is different. In some cases, the pain can be so intense that it affects the general condition of the woman. Most often it is localized in the abdomen, there may radiate to the lower back, pelvis or femur (observed every second woman)
• vegetovascular manifestations. Against the background of pain a woman complained of dizziness, headache, palpitations, numbness of legs, arms. There may be a marked weakness with loss of consciousness. It is also concerned about the dryness of the mouth with a sense of "hot", increased salivation Increased salivation - deviation from the norm , Bloating, diarrhea, frequent urination. The body temperature rises to 38˚S
• emotional and mental symptoms. The general condition of women is changing, the clinical manifestations of dysmenorrhea Dysmenorrhea - the basis of infertility   change its emotional background. There is a tendency to depression, irritability Irritability - you try to control my temper , sleep disturbance Dreams: how to understand our dreams   up to insomnia or, conversely, drowsiness

The reaction of women on the nature of spastic contractions of the uterus during menstruation is largely determined by its sensitivity to the pain tolerance threshold. Predisposes to the development of dysmenorrhea and constitutional type. Asthenic constitution and the existing signs of infantilism can be called predisposing factors. It is proved that this morbid state most prone to neurotic and women with unstable mentality.

Severe pain adversely affects the performance of women. In the early days of the onset of menstruation a woman can not go to work due to intense pain and poor general health. This is a cause of economic losses are associated with disability.

What should be the scope of therapeutic actions

The main task of the physician is to focus all efforts on eliminating the causes of pain and other symptoms. Required treatment should start with raising psychoprophylactic conversation with the patient to create a positive optimistic to treatment.

Given that women may experience constitutional features, it should recommend to the appropriate mode of the day, so that it is optimally alternating load, physical activity and recreation. Directly in the second phase of the cycle and during menstruation is necessary to reduce the physical load. It should be paid attention to diet, since this will also depend on the effect of therapy. The diet should be administered more than fresh fruits and vegetables. In the early days of the onset of menstruation is better to eat food prepared in boiled, stewed and fried, pickled, smoked food excluded.

With regard to medication, then administered vitamin therapy, analgesics, antispasmodics, sedatives, hormones .  Pronounced therapeutic effect is achieved by using Vitamin E which still has anti-oxidant activity .  The daily dose should be 300 mg and it is necessary to take from the start of menstruation for three days .  To facilitate the expression of pain help antispasmodic (tablets or injections shpy, baralgina) and analgesics (analgin) .  It can recommend to prepare special candles, which combines antispasmodic and analgesic effects .  These candles contain extract of belladonna, papaverine and aspirin .  Be sure to assign agents to improve the emotional state of the woman .  When manifestations unexpressed emotional lability is enough purpose herbal products (Valeriana, Leonurus) .

In the event of significant changes in the emotional background resort to stronger medication - tranquilizers, drugs bromine .  A certain importance is given hormone therapy as often contribute to the development of dysmenorrhea hormonal disorders Effectively appointment hormone progestin in the second phase of five days before the expected menstruation .  This will help to reduce the increased uterine tone, eliminate pain .  It may be recommended for a few months of taking combined hormone pills from the group contraceptives (COCs), especially if a woman has revealed signs of genital infantilism .  It is better to use tablets more active progestin component .  Receive mode is selected in the usual way, that is, from the fifth to the twenty-fifth day of the cycle, one tablet a day for three months .  After three months of receiving it is possible to estimate how effective this therapy .  Alternatively, hormone therapy may be used in cyclical therapy appointment estrogen and progestogen hormone respective phases of the cycle .

Marina Solovyov

Heavy periods with clots can occur for various reasons. In order to ascertain the cause of such periods, should see a doctor and if necessary conduct a survey - only then can be assigned to appropriate treatment.

The reason plentiful monthly clotted - congenital malformations of the structure of the uterus

In congenital uterine anomalies structure it may have an irregular shape or septum inside the cavity, which contribute to stagnation of blood in the uterine cavity. As a result, the blood throughout the menstrual isolated as clots. Such heavy menstruation may be due to hormonal disorders, which are often accompanied by malformations of the uterus. Moreover, they are usually painful.

Congenital anomalies of the structure of the uterus may be associated with hereditary diseases, occupational hazards, abuse of certain substances woman during pregnancy (eg, smoking), and so on. There are anomalies such as the doubling of the uterus and vagina, cervix, and split the body of the uterus at the general vagina, forming a rudimentary uterine horn, horned uterus and so on.

The operation is performed after prior thorough examination, including using hysteroscopy Hysteroscopy - examination of the uterus inside   (research on the state of the uterus using a special endoscopic equipment) and hysterography (X-ray of the uterus).

The reason plentiful monthly clotted - hormonal disorders

Hormonal disorders are most often the cause of heavy menstrual period Heavy periods: causes numerous to   clotted. This may be a consequence of violations at any level of the cerebral cortex - the hypothalamus - pituitary - ovary - uterus.

Tumors and diseases of the hypothalamus can stimulate increased secretion of pituitary follicle-stimulating hormone (FSH), the latter will cause premature ripening of the egg, the suppression of secretion of other pituitary hormone (LH), and female sex hormone progesterone, which is secreted by the ovaries. Under the influence of FSH secretion by the ovaries increases the female sex hormones estrogen.

It estrogens contribute to a significant widening of the mucous membrane of the uterus, which is then rejected with heavy bleeding. If the woman observed increased blood clotting, the menstrual blood clots occur. Tumors and diseases of the pituitary gland and the ovaries can cause a similar picture.

Heavy menstruation with clots often occur in the background presence in the uterus intrauterine device. In addition, heavy menstrual bleeding with clots may be a sign of violations of the thyroid and adrenal glands.

In order to understand what changes have led to such violations, conduct a full examination of women, including in cases of suspected pathology of the hypothalamic-pituitary system is carried out with magnetic resonance or computed tomography (MRI, CT) in the area. After identifying the tumors are removed, treated with other hormonal disorders usually conservatively.

The reason plentiful monthly clotted - endometriosis, uterine

Endometriosis is called sprawl areas lining of the uterus to other organs and tissues. Mucosal cells during menstruation fall into the fallopian tube and into the blood, where they can get into any organ. Wherein portions other mucosal tissues (sections endometriosis) behave exactly the same as the rest of endometrium that is undergoing cyclic changes.

In most cases, endometriosis arises in the muscular layer of the uterus. At the same time during menstruation endometriosis areas partially separated from the uterine wall, it violated the integrity of the blood vessels and there are clusters of blood that folds and forms clots.

To make a diagnosis of endometriosis, a woman should be examined. To this end, hosts a variety of lab tests.

Treatment of endometriosis is carried out when he was worried about a woman, including in the menstrual cycle, which can lead to complications such as persistent iron deficiency anemia. Treatment is carried out with the help of hormones (such as progesterone, which inhibits the secretion of estrogen), or quickly.

Any violation of the menstrual cycle require examination and supervision of the gynecologist.

Galina Romanenko