- Dysmenorrhea - the basis of infertility
One of the clinical variants of menstrual dysfunction is dysmenorrhea. It is a pathological condition characterized by the development of the whole complex vegetative symptoms, which largely determine the state of the able-bodied women. About 10% of patients can be temporarily disabled for various periods of time, which determines the value of the social problems of dysmenorrhea.
Why it develops
Painful menstruation are quite common. And it's certainly a reason to see a doctor and undergo a full examination. This is especially necessary to make painful menstruation in adolescents, because if time does not take action, they could be the result of infertility.
The term translates as dysmenorrhea menstrual cycle, but in this case it refers to the menstrual cycle, which manifests itself in painful menstruation, so it would be more correct to call algomenorrhea (the word denotes algo pain). Many women are more or less painful menstruation, dysmenorrhea pain but have high intensity and are accompanied by a number of other symptoms that deprives a woman of efficiency.
Causes of dysmenorrhea may be different, and on this basis dysmenorrhea is divided into primary and secondary.
Primary dysmenorrhea is developed from the beginning, that is, with the first menstruation. Often the reason for it are the various irregularities in the structure of the uterus, in which the blood is retained in its cavity, hormonal disorders, functional disorders of the nervous system, as well as the general lack of development of the musculoskeletal system, including the muscles of the uterus (asthenic constitution). When violations of hormonal pain sometimes pass with age, but not always. If the correct menstrual cycle painless menses not been established for two years, then we speak of primary dysmenorrhea.
Secondary dysmenorrhea is characterized in that arises after some previous disease when initially formed normal menstrual cycle. Often the cause of dysmenorrhea in this case, there are a variety of infectious and inflammatory diseases of the uterus, including those caused by a variety of sexually transmitted diseases. There dysmenorrhea after complicated infections and trauma of abortion and obstructed labor. Often there dysmenorrhea endometriosis (proliferation of sites endometrium inside her muscular layer), and tumors of the uterus.
As a result, the site of inflammation often develop scars, which interfere with normal blood circulation in the uterus, leading to a breach of its muscle contractions, accompanied by painful. In addition, dysmenorrhea changes occur in the central nervous system: block the release of painkillers - opioids that normally carry physiological pain relief during menstruation. This activates prostaglandin synthesis - the substances involved in the formation of inflammation and pain.
What is the reason poor health
The main clinical manifestations of dysmenorrhea associated with a characteristic pain during menstruation and development of vegetative symptoms. It is the severity of autonomic manifestations affect the overall health of women. During the menstrual period is determined by the severity of the following complaints:
- expressed general weakness, malaise
- frustration of a chair
- nausea, vomiting
- fainting with loss of consciousness
Depending on the nature of the disease process and symptoms can be identified and compensated decompensated form of the disease
. If every year there is an increase or buildup of pain and associated symptoms, this means that in dysmenorrhea proceeds decompensated form
. Separately has estimated the severity of the symptoms
. The most favorable course is characterized by mild
. In this case, there is no significant change in the daily activity of women in the days of menstruation, with no systemic symptoms
. Worse associated with vegetative symptoms indicative of disease severity
. In severe dysmenorrhea woman loses efficiency, autonomic symptoms are most severe, pain is not relieved by enough intake of analgesics
Study of the possible mechanism of this disease the subject of many scientific studies. Attaches importance to the role of the influence of "tissue hormones", synthesis and exchange that is broken. These substances are primarily prostaglandins and prostacyclins, leukotrienes, thromboxanes. With increasing content of prostaglandins and other "hormones" occurs spastic contraction of muscular layer of the uterus, and blood vessels. As a result of vasospasm, violation of uterine blood flow develops ischemia of the uterus, is the reason for the formation of persistent pain.
There is a theory of hormonal dysfunction, which is to increase the production of estrogen and progesterone in reducing
Progesterone - norm and pathology
The contractile activity of the muscle layer of the uterus of estrogen dependent since they induce reductions in amplification. Progesterone deficiency, in turn, affect the action of prostaglandins. Progesterone has a stimulating effect on the level of prostaglandins, so the hormone deficiency occurs inhibition of their activity. Identify possible violations in the production of hormones allows the hormone examination. The plan diagnostic procedures patients with dysmenorrhea include hormonal study, together with instrumental methods of diagnosis. When you save a regular cycle, it is necessary to conduct a survey in a strictly reserved for that day. What matters is the fact confirm the presence of a woman's ovulation
Ovulation - How to determine as accurately as possible?
That allow us to make a variety of methods of functional diagnostics and ultrasound scanning.
Characterized by a predisposition to dysmenorrhea in women with a certain type of the constitution. Asthenic constitution, and the downward trend in body weight can be considered a risk factor. Especially clearly this can be seen in adolescents who hold different diets. On these particular constitutional development should pay attention to during the physical examination of a woman who complained of painful menstruation. This is important in case of proven lack of anatomical changes after tool inspection, the normal state of the reproductive system.
The opposite picture emerges in the clinical development against the backdrop of existing dysmenorrhea gynecological diseases. Pathological symptoms can be observed in the following diseases:
- uterine fibroids (if the fibroids are located submucous)
- endometriosis, genital localization
- widespread inflammation in the uterus and appendages
- adhesive disease
To ascertain the cause of pathological symptoms should undergo clinical and laboratory examination with mandatory use of instrumental methods. If necessary, should be carried out histological examination of material from the uterine cavity resulting from separation or scraping during hysteroscopy
Hysteroscopy - examination of the uterus inside
Two clinical variants differ in dysmenorrhea prognosis. All depends on the severity of symptoms. About a favorable outcome is possible to speak in the case of the primary nature of the violations. On the outlook also affects the correct diagnosis, selection of appropriate therapy, which should take into account the nature of the pathological process. Identified organic nature of the disease requires not only the correct medication and surgery.
The main features of
A sign of dysmenorrhea is severe pain in the abdomen
Abdominal pain: when to sound the alarm?
That begin a few days before menstruation and do not stop until the very end of it. Pain may be in the nature of sharp painful spasms (they are more characteristic of primary dysmenorrhea), or be permanent (more in line with secondary dysmenorrhea), but also very strong, to give back, groin and thigh. This leads to the fact that the woman becomes irritable, not sleeping, she constantly headache.
It disrupted the activities of the autonomic nervous system, which provides the function of internal organs and blood vessels. It manifests itself primarily disorders of the digestive organs - nausea, vomiting, drooling, alternating constipation and diarrhea. Blood vessels also respond to what is happening, they are then sharply compressed, it expands, which leads to the "spikes" in blood pressure and disorders of the heart - tachycardia, cardiac pain, and so on.