What is the cause of severe dysmenorrhea?

Severe dysmenorrhea may be caused by primary dysmenorrhea, secondary dysmenorrhea, endometriosis, adenomyosis, pelvic inflammatory disease, etc. It can be improved through drug treatment, hot compress relief, dietary adjustment, moderate exercise, surgical treatment, etc. It is recommended to seek medical treatment promptly to determine the cause of the disease and follow the doctor's instructions for intervention.

1. Primary dysmenorrhea

Primary dysmenorrhea may be related to excessive secretion of prostaglandins and usually manifests as lower abdominal distension and pain 1-2 days before menstruation, which can radiate to the lumbosacral region. When the pain is severe, you can use non-steroidal anti-inflammatory drugs such as ibuprofen sustained-release capsules, acetaminophen tablets, and naproxen sodium tablets as directed by your doctor to inhibit prostaglandin synthesis and relieve pain. Avoid cold and strenuous exercise on a daily basis.

2. Secondary dysmenorrhea

Secondary pain is often related to organic diseases, such as uterine malformation or cervical stenosis. The pain often starts before menstruation and lasts until the end of menstruation. It may be accompanied by increased menstrual flow or cycle disorders, and needs to be confirmed by ultrasound examination. You can use drospirenone and ethinylestradiol tablets and other short-acting contraceptive pills to regulate hormones as directed by your doctor, or consider hysteroscopic adhesion separation.

3. Endometriosis

Endometriosis may be related to reflux of menstrual blood. Typical symptoms are progressively worsening dysmenorrhea and tender nodules on pelvic examination. Medroxyprogesterone acetate tablets, dienogest tablets and other drugs can be used as directed by the doctor to inhibit the growth of the endometrium, or laparoscopic surgery can be used to remove ectopic lesions. Maintaining a low-fat, high-fiber diet can help reduce inflammation.

4. Adenomyosis

Adenomyosis is usually caused by the invasion of the endometrium into the myometrium, which manifests as prolonged menstruation with severe cramping, and ultrasound shows a uniform enlargement of the uterus. Levonorgestrel sustained-release intrauterine system can be used as directed by the doctor to relieve symptoms. In severe cases, hysterectomy is required. Applying heat to the lower abdomen and supplementing with vitamin E can help relieve discomfort.

5. Pelvic inflammatory disease

Pelvic inflammatory disease is often caused by an ascending infection of the reproductive tract. In addition to dysmenorrhea, it is also accompanied by symptoms such as fever and abnormal secretions. The secretion needs to be cultured to identify the pathogen, and ceftriaxone sodium for injection combined with metronidazole tablets should be used for anti-infective treatment as directed by the doctor. In the acute stage, bed rest is required, and sexual intercourse and bathing are avoided.

Women with dysmenorrhea should record the characteristics of pain and accompanying symptoms and provide detailed information when seeing a doctor. Avoid eating cold and spicy foods during menstruation, drink ginger tea or hot brown sugar water every day to promote blood circulation, and choose low-intensity exercise such as walking. If the pain affects normal life or non-menstrual abdominal pain, abnormal bleeding, etc. occur, you must see a doctor immediately to check for organic diseases. People with long-term dysmenorrhea are recommended to have annual gynecological examinations, including ultrasound and tumor marker screening.