Algomenorrhea symptoms. The concept of primary and secondary algomenorrhea in women. What drugs to choose for the treatment of algomenorrhea

Mild discomfort during critical days is experienced by almost all representatives of the beautiful half of humanity. But some women are just stalked unbearable pain. Such malaise even sometimes makes it impossible to work. Painful monthly doctors call algomenorrhea. Why does discomfort occur? And what are the ways to get rid of it?

Description of the pathology: pain, scanty or profuse discharge

Algodysmenorrhea is one of the forms of menstrual irregularity.. It is characterized by severe pain during menstruation. Pathology is accompanied by excessively abundant or scanty discharge.

Algosdysmenorrhea occurs as a result of strong uterine contractions

This condition causes serious discomfort in a woman. In some cases, this is not a sign of pathologies of the genital organs, but most often signals the development of certain diseases.

Doctors, speaking of painful periods, use a few more terms, such as algomenorrhea, dysmenorrhea.

The mechanism of discomfort: what does the presence of blood clots indicate

Every month, a woman's body prepares for the conception of a child, in certain period cycle, ovulation occurs (the release of a formed mature egg from the ovary). This process in some representatives of the fair half causes pain. They can last a few minutes or drag on for the entire period before the onset of menstruation.

Thus, pain before the onset of critical days may indicate successful ovulation.

The uterus is also preparing for the ability to endure a baby. In order to receive a fertilized egg into its bowels, the endometrium (the inner layer of the uterus) thickens under the influence of hormones. But if pregnancy has not occurred, then he begins to be rejected and comes out in the form of menstruation through the genital tract. This process is accompanied by uterine contractions, which cause characteristic pain.

The secretions are a complex mixture containing vaginal cells, blood, particles of the endometrium. Therefore, the presence of clots is a normal physiological phenomenon.. But sometimes it can indicate serious violations in the body.

Classification of pathology

Doctors distinguish several degrees of algomenorrhea, depending on the severity of symptoms:

1. Easy degree. This form is characterized by moderate short-term discomfort. Pain does not disrupt the usual way of life and does not lead to disability. The problem most often disappears after childbirth.
2. Average degree. A woman is tormented by a rather pronounced discomfort, weakness appears. Psycho-emotional disruptions join the malaise, which can be expressed by irritability, depression intolerance to sounds or smells. The performance is greatly reduced.
3. Severe degree. Pain is pronounced. The malaise may be accompanied by disturbances in the functioning of the heart, gastrointestinal tract, and the autonomic system. During menstruation, a woman completely loses her ability to work.

Primary dysmenorrhea occurs during adolescence

According to the mechanism of occurrence, dysmenorrhea is divided into:

1. Primary. Painful sensations appear during adolescence. Usually dysmenorrhea is observed in excitable girls, characterized by emotional instability. Most often, primary algomenorrhea is not associated with pathologies of internal organs. Although such causes can be completely excluded only after examination.
2. Secondary. This pathology develops in adult women, as a rule, after 30 years. The occurrence of painful periods is dictated by acquired diseases of the genital area.

Primary dysmenorrhea is divided into 3 types:

1. Spasmodic. The appearance of pain provokes severe spasms of the uterus. The condition resembles in its manifestations "mini-birth".
2. Essential. This type pathology is associated with a low pain threshold in women.
3. Psychogenic. Usually girls with an unstable psyche suffer, anxiety states, fear of pain, a tendency to tantrums.

Why do painful periods occur in girls and women

Doctors believe that different factors underlie primary and secondary algomenorrhea.

Causes of primary dysmenorrhea in adolescence

Unpleasant discomfort appears in girls 6–18 months after the onset of menstruation. It is at this time that they set the process of ovulation..

The causes of primary algomenorrhea can be:

1. Hormonal changes. Phase 2 of the cycle is characterized by a deficiency of endorphin and enkephalin (happiness hormones). At the same time, the formation of prostaglandins increases. Such changes in hormonal background cause pain.
2. Tuberculosis of the genital organs. Pathology, which has been developing since childhood, leads to various anomalies in the development of the genital organs. Menstruation may be absent or manifest as scanty discharge accompanied by severe pain.
3. Developmental Disorders connective tissue which are often inherited. Anomalies can cause various pathologies: scoliosis, pelvic tilt, bowel problems. These changes provide negative impact on the genital area(squeeze, lead to bending of the organs), as a result of which the girl experiences discomfort. In addition, with such disorders, magnesium deficiency is detected.
4. Diseases of the nervous system. Women suffering from psychosis, various neuroses, often have a heightened perception of pain.
5. Abnormal structure of the reproductive system. Underdevelopment of the uterus, kinks of the organ lead to severe pain during menstruation. The pathological structure worsens the outflow of blood from the cavity. The uterus is forced to contract more strongly. The result is severe pain.

Causes of secondary pathology: hysteroscopy with curettage, inflammation, IVF, removal of an ovarian cyst, Regulon cancellation, taking Duphaston, Postinor, Qlaira and other drugs

Painful discomfort in women can develop for the following reasons:

Symptoms accompanying algomenorrhea: pain, fever, depression and others

Dysmenorrhea, depending on the strength of manifestations, can provoke a whole "bouquet" of unpleasant symptoms:

Such signs in secondary algomenorrhea are complicated by symptoms gynecological pathology causing painful periods.

Diagnosis: what tests should be done

If there are unpleasant symptoms that seriously reduce the quality of life, the patient should go to the gynecologist for an appointment.

The examination begins with a questioning of the woman:

1. About clinical manifestations (when the malaise appeared, what symptoms are accompanied, how long the discomfort lasts, where the pain is localized).
2. About the menstrual cycle (when menstruation began, how long it lasts, their abundance, regularity).
3. O gynecological diseases(whether there were previous diseases, whether there were surgical interventions).

Then the patient will undergo the following examinations:

Depending on the results of the tests performed, consultations of narrow specialists may be required: an endocrinologist, a urologist, a psychologist, a surgeon, a mammologist, a psychiatrist.

Treatment Methods

For the treatment of algomenorrhea are used non-drug methods and drug therapy.

To non-drug methods include:

• dietary intake;
• psychotherapy;
• gymnastics, yoga;
• massage.

Drug therapy is prescribed individually, depending on the detected pathologies in the woman's body, characteristic symptoms and strength of manifestation of dysmenorrhea.

Diet food: essential vitamins and minerals

To help reduce pain:

1. Vegetable juices. They should be started a few days before the onset of menstruation. Very helpful beetroot juice, carrot, parsley drink.
2. Cellulose. It is advisable to introduce bran, rice (unpolished), vegetables into the diet.
3. Protein and iron. To replenish such substances, it is necessary to diversify the menu with liver, buckwheat.
4. Calcium, magnesium, potassium. These trace elements help to reduce the tone of the uterus, thereby reducing pain. To enrich the body with such minerals, nutrition should include:
   • string beans;
   • cottage cheese;
   • tomatoes;
   • yogurt;
   • green salad;
   • milk.
5. Vitamin E, especially in the first 3 days of menstruation. The supply of this substance will provide:
   • avocado;
   • corn;
   • olives;
   • beans.
6. Bananas. delicious product contains big number"happiness hormone" Therefore, with violations in the hormonal background, bananas can significantly reduce discomfort.
7. Ginger tea. It can be drunk with honey. Peppermint and chamomile teas also have analgesic properties.

Recommended products for the female body with dysmenorrhea - gallery

Wet juice is useful for dysmenorrhea
Unpolished rice will saturate the body with fiber
Beef liver provide iron and protein
Cottage cheese, milk will enrich the body with calcium, magnesium, potassium
Olives saturate the body with vitamin E
Banana is a real storehouse of the "hormone of happiness"
Ginger Tea Significantly Reduces Dysmenorrhea Pain

Massage

Helps to cope with unpleasant symptoms:

1. Acupressure. It is necessary to press for 1.5–2 minutes on a point located on the inner surface of the knee.
2. Lumbar massage. You will need 2 small balls (for example, tennis). They are lowered into a regular sock or a bag of fabric so that they do not roll anywhere. On this "simulator" they lay down with their backs. The balls should be placed on both sides of the spine. It takes a few minutes to roll them with muscles.

During menstruation, heavy loads are contraindicated. They can increase bleeding in a woman. BUT hiking, simple gymnastics, yoga can bring significant relief.

Research scientists have confirmed that athletes are much less likely to suffer from algomenorrhea.

You can practice the following exercises:

Drug therapy: Aspirin, Papaverine, Magne B6 forte, Asparkam and other drugs

Medicines that can help a woman endure dysmenorrhea are prescribed by a doctor.

Usually therapy includes such groups of medicines:

1. Non-steroidal anti-inflammatory drugs. This is the main group of drugs used for algomenorrhea, which reduces pain, eliminates inflammation, and relieves swelling. Appoint:
   • Aspirin;
   • ibuprofen;
   • Paracetamol;
   • Naproxen;
   • Ortofen;
   • ibuprofen;
   • Diclofenac;
   • Voltaren;
   • Indomethacin.
     

     The following medicines perfectly block the growth of prostaglandin: Ketazon, Surgam, Sulindak, Reopirin, Piroxicam, Ketoprofen, Pirabutol, Nifluril, Butadion, Donalgin. They help to cope with pain and relieve heat Tsefekon (candles), Nise.

2. Antispasmodics. Sometimes combined medicines are recommended, which not only eliminate pain, but also relieve muscle spasms. These medicines are:
   • Spazmalgon;
   • Maxigan;
   • Spazgin;
   • Trigan;
   • Minalgan.
     

     Some doctors advise combining NSAIDs with such antispasmodics: Platifillin, Papaverine, No-Shpa, Metacin, Sirdalud.

3. Antihistamines combined with sedatives. This combination is used for severe pain. The drugs are administered intravenously or intramuscularly. Dimedrol, Suprastin are used as antihistamines. From sedatives choose Sibazon, Relanium.
4. Combined contraceptives. These medicines can only be prescribed by a doctor, after weighing the condition of the woman and analyzing the contraindications. Benefits can bring:
   • Ovidon;
   • Norkolut;
   • Turinal;
   • Microgynon;
   • Marvelon;
   • Orgametril.
5. Vitamin complexes. To ensure the entry of minerals and vitamins into the body, the patient is prescribed:
   • Magne B6 forte;
   • Calcium D3 Nycomed;
   • Pentovit;
   • Neuromultivit.
   • vitamin E;

For adolescent girls, the most suitable medications are ibuprofen-based NSAIDs. For older women and menopausal women, hormonal therapy is most often recommended.

Medicines for algomenorrhea: tablets, suppositories - gallery

Magne B6 forte saturates the body with the necessary magnesium
Papaverine relieves muscle spasms and pain
Asparkam replenishes magnesium and potassium deficiency in the body
Meloxicam is an excellent pain reliever and anti-inflammatory agent.
Sirdalud relieves spasms
Rigevidon is taken to normalize hormonal levels

Physiotherapy methods

Hardware physiotherapy is widely used to combat algomenorrhea. It is carried out on the eve of menstruation or in the second phase of the cycle.

1. Phonophoresis, electrophoresis using solutions: Novocain, Sodium bromide, Antipyrine, Trimecaine.
2. Pulsed ultrasound on the lower abdomen.
3. Short-wave diathermy is an electrotherapeutic method based on the use of high-frequency alternating electric current.
4. Galvanized collar with nicotinic acid, bromine, calcium (according to Shcherbak A.V.).
5. DDT, SMT - exposure to pulsed low-frequency currents.
6. Reflexology.

Folk remedies: what herbs are used

With menstrual pain, recipes of traditional healers will bring help:

1. Viburnum bark:
   • crushed raw materials (4 tsp) are poured with water (1 tbsp.);
   • the composition is boiled for half an hour;
   • filter;
   • ordinary boiled water is added to the liquid to obtain the initial volume;
   • take a decoction three times a day for 1 tsp. before eating.
2. Medicinal infusion:
   • combine lemon balm leaves and chamomile flowers in a ratio of 1: 1;
   • ready-made collection (1 tbsp.) Pour boiling water (1 tbsp.);
   • for half an hour, the remedy is insisted, then filtered;
   • take three times a day for 1-2 tbsp. l. before meals. It is necessary to start treatment a few days before the onset of menstruation, and finish - after it ends.
3. Medicinal teas. Drinks from raspberry leaves, chamomile flowers can reduce pain. Teas made from mint, catnip, strawberry leaves are useful. To relieve puffiness, drinks from herbs with diuretic properties (horsetail, bear ears) are recommended.

Folk remedies for algomenorrhea - gallery

homeopathic treatment

Homeopathy provides excellent results. These drugs affect female body soft yet effective.

The following homeopathic remedies can be used:

1. Menonorm. Recommended for PMS premenstrual syndrome), algomenorrhea, in menopause. Favorably affects the sexual sphere, strengthens the cardiovascular and nervous systems.
2. Basin. Used to reduce pain in dysmenorrhea. Often used in menopause.
3. Ginereg. The drug is intended for the treatment inflammatory pathologies genital organs of a woman, such as colpitis, endometritis, adnexitis.
4. Feminus. It is used for menstrual irregularities, chronic inflammation, during menopause. The drug has a beneficial effect on the autonomic and central nervous systems.
5. Dysmenorm. It is prescribed for PMS, dysmenorrhea. The drug eliminates severe bleeding, regulates the cycle.
6. Klimadinon. The medicine is effective replacement hormonal medications. It is prescribed to eliminate psycho-emotional, vascular disorders in a woman during menopause, as well as before and after menopause.
7. Gynocoheel. The medicine is intended to improve the functioning of the female reproductive system. The drug has an anti-inflammatory effect. Therefore, it is often recommended for salpingitis, endometritis.

Prognosis and possible complications

The prognosis for algomenorrhea is quite favorable. Properly selected methods of treatment can normalize the condition. In most cases, there is complete relief from pain.

The prognosis of secondary dysmenorrhea depends on the disease underlying the development of menstrual pain.

Consequences: what can happen if the pathology is not treated

With absence adequate treatment Algodysmenorrhea can lead to negative complications of 2 types:

1. in the reproductive system. If the development of dysmenorrhea is based on gynecological diseases, then ignoring the pathology leads to its progression. To fight with severe forms much more difficult. Many gynecological diseases lead to infertility. And some of them can transform into oncology.
2. In general health. Psychosomatic disorders may underlie the development of psychosis, depression. In addition, without appropriate therapy during menstruation, a woman's ability to work will decrease.

Preventive actions

1. Treat all inflammatory, infectious diseases of the genital area correctly and in a timely manner.
2. Observe personal hygiene.
3. Eliminate bad habits.
4. Stick to right image life (good nutrition, appropriate physical activity).
5. Visit a gynecologist.
6. With dysmenorrhea, follow all the recommendations prescribed by the doctor to eliminate discomfort.

Painful menstruation - video

Algodismenorrhea is an extremely unpleasant condition that can annoy a woman for years. Should I endure such discomfort? Due to the rapid development of medicine modern doctors have many tools in their arsenal that can help each patient cope with excruciating monthly discomfort.

M. V. Mayorov

Algodysmenorrhea: pathogenesis, diagnosis, treatment

Women's consultation of the Medical Unit No. 2 KhZTD, Kharkiv

Algodysmenorrhea is a symptom complex characterized by neurovegetative disorders and pain during menstruation. In the presence of only pain syndrome we are talking about algomenorrhea, or menalgia. The previously used term "dysmenorrhea" does not reflect the essence of the observed phenomena, characterized mainly by pain.

It should be noted that algomenorrhea is very common in the practice of an obstetrician-gynecologist. According to V.I. Bodyazhina et al. (1990), painful menstruation is observed in 31-52% of women aged 14-44 years, and in about 10% of them the pain is so intense that it disrupts the ability to work. The observations of researchers from Australia, Sweden, and others testify to an even greater prevalence of this suffering, which is considered for this reason not only as a medical, but also as a social problem.

Usually, algomenorrhea is divided into primary (essential), not associated with anatomical changes in the genital apparatus, and secondary, due to pathological processes of the genitals. Primary algomenorrhea is observed more often in girls and nulliparous women and is characterized mainly by acute convulsive pains in the abdomen, reminiscent of labor pains. Pain syndrome occurs, as a rule, with the first menstruation in life, less often - after some time. Usually there is an astheno-neurotic syndrome in combination with genital hypoplasia, however, there are frequent cases of severe algomenorrhea in physically well-developed patients without visible signs hypoplasia of the genitals and instability of the central nervous system.

For a long period, it was believed that the pain associated with menstruation was of a psychogenic (neurogenic) nature, some authors observed neuroendocrine changes, disorders of mineral, carbohydrate, hormonal metabolism, changes in the bioelectrical activity of the brain, etc. Currently, the development of algomenorrhea is explained excessive synthesis of prostaglandins (PG). Evidence of the pathogenetic role of PG in algomenorrhea are the following arguments: the use of non-steroidal anti-inflammatory drugs that suppress the synthesis of PG, reduces or completely eliminates the symptoms of the disease; the experiment revealed that PG increase myometrial contractility, arteriole vasoconstriction and, as a result, endometrial ischemia, which causes pain. PG also act on sensory nerve fibers and increase sensitivity caused by increased pressure in the uterine cavity with excessive contractility of the myometrium. Consequently, the mechanism of pain in primary algomenorrhea is practically the same as in acute myocardial ischemia - arterial spasm and bleeding of muscle tissue. Hyperprostaglandinemia is not only local. spastic headache, nausea, vomiting, paresthesia, diarrhea, sweating, chills, tachycardia observed in algomenorrhea syndrome clearly illustrate this.

Secondary dysmenorrhea is usually symptomatic. Therefore, it is very important to diagnose the diseases that cause the appearance of this syndrome. These diseases include inflammatory processes of the internal genitalia, adhesions in the pelvis, uterine fibroids, acute-angled anteflexia of the uterus, narrowing of the internal os of the cervix after curettage. In some cases, the functional layer of the endometrium during menstruation is separated in the form of a continuous membrane, a “cast of the uterus” (the so-called “membranous dysmenorrhea” - according to the old terminology, without being subjected to enzymatic melting, as is the case with normal menstruation. Isolation from the uterus of an unmelted "cast" of the endometrium is accompanied by extremely severe cramping pains.

The syndrome of algomenorrhea is one of the leading ones in the clinical picture of endometriosis, in which inclusions are determined in the muscular layer of the uterus (adenomyosis) or in other organs of the reproductive system and outside it (extragenital endometriosis), similar in structure and function to the endometrium. Characteristic of endometriosis, in contrast to primary algomenorrhea, are long-term (within 2–5 days) intense menstrual pain, their almost constant irradiation to the sacrum and rectum, low-grade fever, and accelerated ESR during menstruation. Very characteristic of endometriosis is a significant increase in the size of the uterus before and during menstruation and a decrease after. Mention should be made of algomenorrhea in some women using BMS. It was noted that their concentration of PG in the endometrium is significantly increased.

Among more rare causes secondary algomenorrhea should be attributed to Allen-Masters syndrome (ruptures of the posterior leaf of the broad ligament of the uterus, observed after traumatic childbirth with large fruit, the imposition of obstetric forceps, rapid childbirth, etc.). Varicose veins of the pelvic veins at the base of the broad ligament and own bundle ovary, as well as malformations of the genitals with unilateral obstruction of the outflow menstrual blood(additional closed uterine horn, additional closed vagina, etc.) also often cause algomenorrhea syndrome. A characteristic symptom of algomenorrhea, which occurs with malformations of the genitals, is an increase in the pain of menstruation from the moment they appear and the young age of patients. Based on the foregoing, a very thorough differential diagnosis of primary and secondary forms algomenorrhea. We indicate diagnostic criteria primary algomenorrhea, cited by V. I. Bodyazhina et al. (1990):

It is necessary to resolutely reject the widespread, unfortunately, opinion among many doctors about the optional treatment of algomenorrhea (“so for everyone”, “everything will pass after marriage and childbirth”, etc.). Such "consolations" are unacceptable, since after marriage and childbirth, algomenorrhea does not always "pass away", but often intensifies. Timely, properly selected and regularly carried out treatment allows in most cases to achieve a significant therapeutic effect, and often completely eliminate very painful painful symptoms.

The main method of treatment is the use of prostaglandin synthetase synthesis inhibitors, also called non-steroidal anti-inflammatory drugs. These include: acetylsalicylic acid(aspirin) at a dose of 0.25-0.75 g 3-4 times a day after meals, paracetamol - 0.5-1.0 g 2-4 times a day, ibuprofen (brufen) 0.2-0 .4 g 3-4 times a day after meals, naproxen (naprosin) - 0.25-0.5 g 3-4 times a day after meals, diclofenac (ortofen, voltaren, revodina) - 0.025-0.05 each g 2-3 times a day after meals, indomethacin (methindol) - in the same doses or rectally in the form of suppositories. Successfully used drugs such as ketazon, surgam, piroxicam, ketoprofen, sulindac, mefenamic acid, reopyrin, pirabutol, butadione, donalgin, nifluril, etc. in appropriate doses. The main principle of treatment with prostaglandin synthesis inhibitors is early (preventive) administration. medicines 2-4 days before the onset of menstruation (appearance of pain) and during the next 2-4 days. In this case, menstrual pains, if they appear, are much less pronounced against the background of the treatment and are easier to tolerate by patients. It is very useful to use combined preparations such as renalgan (baralgin, trigan, maxigan, minalgan, spazgin, spazmalgin, spasmalgon, veralgin) containing, in addition to analgin, in a sufficiently high dose (0.5 in a tablet, 2.5 in a 5 ml ampoule ) two effective antispasmodics. These drugs are prescribed 1-2 tablets 2-3 times a day (regardless of food intake) according to the above scheme in advance, and with insufficient effect or very strong menstrual pain ("menstrual colic"), they can be administered intramuscularly or intravenously at a dose of 2 -5 ml, slowly over 3-5 minutes, sometimes mixed with antihistamines (diphenhydramine 1% - 1-2 ml, chloropyramine (suprastin) 2% - 1 ml) and sedatives (relanium, sibazon 0.5% - 2 ml ) drugs. Usually treatment is carried out within 3-4 menstrual cycles. With inefficiency or insufficient effectiveness for the treatment of both types of algomenorrhea, in the absence of contraindications, COCs are used (combined oral contraceptives).

The most effective drugs with a high content of the progestogen component (ovidon, rigevidon, microgynon, marvelon), which are used according to the contraceptive regimen for 21 days, starting from the 1st (5th) day of the menstrual cycle. Quite effective is the appointment of "pure" gestagens: norkolut (norethisterone), turinal, acetomepregenol, orgametril, dufaston (dydrogesterone) - 5-15 mg per day from the 14-16th to the 25th day of the menstrual cycle. Previously, intramuscular administration of progesterone 1% was used - 2-3 ml daily or every other day on the eve of menstruation - 4-6 injections. E. M. Govorukhina proposed a method of treatment by desensitization with hormones, which consists in intradermal administration 8–10 days before menstruation of 0.1 ml of estradiol dipropionate 0.1% and the same dose of 1% progesterone solution into the region of the inner surface of the forearm at a distance of 3 see from the first injection. There are 3 courses in total. According to I. L. Luzina and L. P. Bakuleva, a good therapeutic effect with primary algomenorrhea, it gives the use of a-tocopherol acetate (vitamin E) at a dose of 300 mg per day in the first three days of painful menstruation.

With insufficient effectiveness of prostaglandin inhibitors, it is advisable to combine them with antispasmodics (papaverine, platifillin, metacin, atropine, no-shpa, halidor, buscopan). Quite effective is the sublingual use of calcium antagonists: nifedipine (Corinfar, Cordafen, Adalat), fenigidin 10–30 mg once, recommended by Italian and French authors. In some cases, it is useful to use ergot alkaloids inside - 0.1% solution of ergotamine hydrotartrate or dihydroergotamine (dihydroergotoxine) - 10-20 drops each.

In almost all cases of algomenorrhea, one should strongly warn against the use of narcotic analgesics.

Hardware physiotherapy, carried out in the second phase of the menstrual cycle or on the eve of menstruation, is widely used: electrophoresis and phonophoresis of solutions of novocaine, trimecaine, magnesium sulfate, antipyrine, sodium bromide on the lower abdomen and the solar plexus area, galvanic collar according to A. V. Shcherbak with calcium, bromine, nicotinic acid, ultrasound on the lower abdomen in a pulsed mode, pulsed low-frequency currents (DDT, SMT), short-wave diathermy, central electroanalgesia, etc.

AT recent times reflexology is used with some success. We should not forget about the old folk phytotherapeutic agents (various collections of medicinal herbs), homeopathic preparations (menalgin, dysmenorm, etc.), as well as pay sufficient attention to the normalization of the psycho-emotional sphere (sedative drugs), the elimination of psycho-traumatic stressful situations, rational psychotherapy (talks about treatability pain, their safety for life due to the absence of serious diseases, compliance optimal conditions life, work, food, rest, etc.).

In the practice of doctors of various specialties, there are often situations when, under the guise of algomenorrhea, various acute diseases occur that require urgent hospitalization, and often surgical treatment (acute appendicitis, acute intestinal obstruction, renal colic, acute cholecysto-pancreatitis, torsion of an ovarian cyst or its apoplexy, acute inflammatory diseases of the pelvic organs, accompanied by the development of a tubo-ovarian abscess with its possible breakthrough into the abdominal cavity and the development of peritonitis, etc.). Algodysmenorrhea greatly complicates the diagnosis of other diseases that have arisen against its background, but nevertheless, with a carefully collected history and a thorough objective examination (with mandatory vaginal and rectal examination), it is possible to find out that the nature, localization, and irradiation of pain in this case are somewhat different than usual during menses. Particular attention should be paid to peritoneal phenomena, tachycardia, dryness of the tongue and other symptoms indicating the development of an "acute abdomen" blade.

Literature

1. Bodyazhina V.I. and others. Non-operative gynecology.- M., 1990.
2. Vasilevskaya L. H. and others. Gynecology. - M., 1985.
3. Kobozeva N.V. and others. Gynecology of children and adolescents.- M., 1988.
4. Mayorov M.V. Emergency Diagnostics acute gynecological diseases // Paramedic and obstetrician.- 1974.- No. 9.- P. 29–33.
5. Mayorov M.V. Diagnosis and treatment of algomenorrhea // Paramedic and midwife.- 1979.- No. 2.- P. 31–34.
6. Mayorov M. V. Algomenorrhea - treatment is necessary // Medicine and ... - 1998. - No. 2. - P. 27–29.
7. Malevich K. I. Rusakevich P. S. Treatment and rehabilitation for gynecological diseases. - Minsk, 1994.
8. Akezlund M. Pathophysiology of dysmenorrhoea. J. Reprod. Med (Suppl.), 1979.
9. Zundstrom V., Green K. Endogenous levels of prostaglandin F2b and its main metabolites in plasma and endometuosis of normal and dysmenorrheis women. amer. J. Obst. Gynecol. 1978. Vol. 130.- P. 640–646.
10. Mohr A., ​​Haenel A. Secundare Dysmenorrhoe. Therapic Umschau.- 1983.- Bd. 40.- No. 7.- S. 634-641.
11. Rygdeman M. et al. Effect of Hre prostaglandins on the utews. Acta Obstet Gynecol Scand. (Suppe).- 1979.- Vol 87.- P. 33-38.
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13. Sobezik R. Dysmenorrhea. The nyllected syndrome. J. Reprod. Med. (Suppl.).- 1980.- No. 25.- P. 198–201.

- painful menstruation, accompanied by a violation of the general condition. Occurs with anomalies in the development of the uterus, hormonal disorders, increased excitability of the central nervous system, organic lesions uterus due to certain inflammatory and non-inflammatory diseases, abortions and complicated births. Algodismenorea is characterized by aching or cramping pains in the lower abdomen during the first days of menstruation. Weakness, nausea, edema, headaches, dizziness, sweating, stool disorders and decreased performance are possible. The diagnosis is established on the basis of anamnesis, complaints and data objective research. Treatment tactics depend on the cause of the disease.

Causes of algomenorrhea

The reasons for the development of primary algomenorrhea can be mechanical, endocrine, neuropsychogenic and constitutional. To the number mechanical causes include abnormalities in the development of the uterus, violations of the position of the uterus (hyperanteflexia), cervical atresia and other pathological conditions that create an obstacle to the normal outflow of menstrual blood. endocrine cause algodysmenorrhea is an excessively active synthesis and a slow process of disintegration of prostaglandins.

Prostaglandins increase the contractility of the muscular layer of the uterus, cause spasm of the arterioles, which leads to a deterioration in the blood supply to the myometrium, and act on the nerve fibers in the wall of the uterus, increasing their sensitivity to pain. Prolonged vasospasm, increased uterine contractions and increased pain sensitivity provoke pain syndrome. Other symptoms of algomenorrhea are also associated with an increase in the level of prostaglandins: nausea, diarrhea, palpitations, chills, hyperhidrosis, dizziness, etc.

Among the neuropsychogenic reasons for the development of algomenorrhea, experts call an individual decrease in the threshold of pain sensitivity, a hidden rejection of one's feminine essence, a denial of the sexual aspects of life and oneself, as a woman and mother. The constitutional cause of algomenorrhea is infantilism. Hypoplasia of the uterus and insufficient development of the myometrium reduce the ability of the organ to stretch during menstruation. The pressure on the walls of the uterus increases, this causes irritation of sensitive nerve fibers and the appearance of pain.

Secondary (symptomatic) algomenorrhea occurs as a result of inflammatory and non-inflammatory diseases of the female genital organs, surgical interventions, adhesions in the pelvis, complicated childbirth and damage to the cervix during curettage. The most common cause of secondary algomenorrhea is adenomyosis and external endometriosis. Pain during menstruation in these diseases is due to desquamation of heterotopic areas of the endometrium.

Cell separation is accompanied by irritation of a large number of nerve fibers in the wall of the uterus, peritoneum, other organs and tissues containing heterotopic endometrial cells, and causes sharp increase prostaglandin levels. The release of prostaglandins provokes intense pain and general malaise. In many patients, secondary algomenorrhea develops against the background of submucosal uterine fibroids. Myoma prevents the outflow of menstrual blood, the uterus begins to contract more intensively, the pressure in its wall rises, the nerve fibers are irritated, prostaglandins are released, and pain appears.

Algodysmenorrhea also often appears with inflammatory diseases, especially - chronic, long-term current. This is due to the fact that inflammation provokes the formation of adhesions, and the adhesive process entails a violation of the location of the uterus and the appearance of mechanical obstacles to the normal outflow of menstrual blood. In addition, inflammation is accompanied by tissue swelling and compression of nerve fibers and in itself causes pain, aggravated by uterine contractions.

In some cases, algomenorrhea develops after the installation of an intrauterine device that stimulates the production of prostaglandins. In some patients, the symptoms of algomenorrhea appear after a rough curettage during an abortion or after a complicated birth. The cause of algomenorrhea in such cases is a rupture of the posterior leaf of the broad ligament of the uterus or varicose veins of the small pelvis. Sometimes, with secondary algomenorrhea, there is a separation of the “cast of the uterus” - a condition in which the functional layer of the endometrium does not undergo melting in the uterine cavity, but leaves it in the form of a whole film. The release of such a film is accompanied by very intense cramping pains.

Symptoms of algomenorrhea

Primary algomenorrhea is usually detected in sensitive, emotionally unstable girls of asthenic physique with a tendency to underweight. Secondary algomenorrhea is more often diagnosed in women over the age of 30 years. Patients have a history of abortions, intrauterine device, childbirth, operations on the pelvic organs, infertility, inflammatory (endometritis, cervicitis, adnexitis, salpingitis, oophoritis) and non-inflammatory (adenomyosis, interstitial uterine fibroids, endometriosis, polycystic ovaries) diseases of the female genital organs.

Patients complain of pain and worsening of the general condition. Pain syndrome with algomenorrhea occurs simultaneously with the onset of menstruation or a few hours before it begins. The pains are often cramping, less often - pulling, aching or arching. Possible irradiation to the lumbar region, groin, perineum, rectum, or upper part inner thighs. The intensity of the pain syndrome in algomenorrhea may vary. Both moderate pains are possible, which do not have a significant effect on working capacity, are well eliminated by conventional analgesics or antispasmodics, and extremely intense, requiring professional medical care.

Violation of the general condition with algomenorrhea is manifested by vegetative-vascular, metabolic and emotional psychological disorders. Shortly before the onset of menstruation and in the first days of menstruation, a woman suffering from algomenorrhea becomes touchy and irritable, overly worried about minor reasons. There may be a steady decrease in mood, drowsiness, an increase or decrease in appetite, a perversion of taste and intolerance to odors.

Vegetative and vascular disorders in algomenorrhea are manifested in the form of hiccups, belching, nausea, vomiting, dry mouth, diarrhea, bloating, fever, chills, fever to subfebrile numbers, increased urination, dizziness, headache, fainting and pre-syncope, pain and discomfort in the region of the heart, an increase or decrease in heart rate, extrasystoles, numbness and coldness of the extremities. Metabolic disorders in algomenorrhea indicate pruritus an increase in the amount of urine excreted, general weakness, feeling of weakness in the legs and flying pains in the joints.

For diseases of the female genital organs clinical picture algomenorrhea may become somewhat more complicated or modified due to the overlap of symptoms of the underlying disease. Depending on the characteristics of the course, two forms of algomenorrhea are distinguished - compensated and decompensated. In patients with a compensated form of the disease, the symptoms remain stable for many years. In patients with a decompensated form, increased pain and aggravation of general condition disorders over time are detected.

Diagnosis of algomenorrhea

The diagnosis is made on the basis of complaints, anamnesis and data additional research. The gynecologist finds out when the patient with algomenorrhea first experienced pain during menstruation, what is the duration of the pain, whether the pain is accompanied by a violation of the general condition, whether the patient with algodysmenorrhea suffers from gynecological diseases, whether there was a history of childbirth, abortion and operations on the female genital organs. During the survey, the doctor determines at what age menstruation began, what is the duration of the cycle, how often there are violations of the cycle and how heavy menstruation is.

After collecting complaints and clarifying the anamnesis, the specialist conducts a gynecological examination, takes a smear from cervical canal, vagina and urethra. Then a woman with algomenorrhea is sent for an examination, which includes ultrasound of the pelvic organs, general analyzes blood and urine tests, testing for sexually transmitted diseases and hormone levels. To clarify the ultrasound data, CT and MRI of the pelvis are used. With algomenorrhea, presumably caused by polyposis and endometriosis, hysteroscopy and separate diagnostic curettage are prescribed. In some cases, laparoscopy is performed. If necessary, a patient with algomenorrhea is referred to a urologist, psychologist, psychotherapist and other specialists.

Treatment of algomenorrhea

Treatment of algomenorrhea is carried out in outpatient settings. The classic method of treatment is pharmacotherapy in combination with physiotherapy. In the presence of gynecological diseases, tactics are determined depending on the underlying pathology. Patients with algomenorrhea are prescribed non-steroidal anti-inflammatory drugs that inhibit the synthesis of prostaglandin synthetase. It is recommended to start taking drugs for algomenorrhea 2-4 days before the onset of menstruation and stop 2-4 days after it starts. Aspirin, paracetamol, ibuprofen, naproxen, diclofenac and their analogues are used.

With algomenorrhea is also widely used combined means, which include analgesic and antispasmodic. If algomenorrhea is accompanied by a very intense pain syndrome, drugs are administered intravenously or intramuscularly for 3 or 4 cycles, sometimes in combination with sedatives and antihistamines. In the absence of the effect of analgesics and antispasmodics, patients with algomenorrhea are prescribed oral contraceptives containing ethinyl estradiol and levonorgestrel.

In the second phase of the cycle or shortly before the onset of menstruation, patients with algomenorrhea are referred for phonophoresis and electrophoresis with sodium bromide, magnesium sulfate, trimecaine or novocaine. Patients with algomenorrhea are prescribed short-wave diathermy, diadynamic currents and ultrasound. Some specialists use reflexology. In the presence of psychoemotional disorders, treatment by a psychologist or psychotherapist is indicated. Patients with algomenorrhea are given psychological support, appoint sedatives, teach relaxation techniques, conduct explanatory talks about the nature of algomenorrhea and its safety for life.

Women suffering from algomenorrhea are advised to give up bad habits, avoid drinking strong caffeinated drinks, normalize the daily routine, eliminate stress factors if possible, reduce weight (in case of excess body weight), follow a balanced diet, maintain moderate physical activity. Primary dysmenorrhea usually responds well to treatment. The prognosis for secondary algomenorrhea depends on the type and characteristics of the course of the underlying disease.

Algodysmenorrhea not only brings discomfort and reduces the quality of life of a woman, but can also be the result of the development of a pathological process. The appearance of painful periods is the basis for a consultation with a medical specialist. Early detection and treatment pathological causes algodismenorea is the basis for the prevention of the development of possible complications.

And now let's dwell on this in more detail.

What is "algodysmenorrhea"?

The term algodysmenorrhea defines a pathological condition that affects the reproductive system of a woman and is accompanied by painful menstruation. The mechanism of development (pathogenesis) of pain during menstrual bleeding is associated with the implementation of several links:

• Direct rejection of the functional layer of the endometrial epithelium of the uterus, which is accompanied by spasm of arterial vessels and bleeding.
• Increased tone of the smooth muscles of the walls of the uterus (myometrium).
• Development inflammatory process in violation of the course of the processes of the menstrual cycle - cells accumulate in the tissues immune system, which produce biologically active compounds mediators inflammatory response(prostaglandins). They irritate the sensitive nerve endings, and also lead to the development of tissue edema with mechanical compression.

Implementation of each pathogenetic mechanism the occurrence of pain depends on the underlying cause of the development of algomenorrhea. pathological origin pain is a common phenomenon that is recorded in 30% of women of reproductive (childbearing) age. Depending on the main causes and mechanism of development, 2 main types of algomenorrhea are distinguished:

• Primary (essential) algomenorrhea - pain sensations develop already in adolescence with the appearance of the first menstrual bleeding.
• Secondary (symptomatic) algomenorrhea - a pathological condition develops in adult woman, usually due to various diseases reproductive system.

With the development of secondary algomenorrhea, the main direction therapeutic measures is to exclude further exposure causative factor. If painful periods are of primary origin, then lifelong maintenance treatment is often required, in the absence of which discomfort quickly resume. Knowing the pathogenesis and determining the type of algomenorrhea in a woman allows you to choose the most optimal therapeutic measures.

The first signs of algodismenoria

The main first manifestation of algomenorrhea in a woman is. It appears before the onset of menstrual bleeding and has varying degrees of severity. Along with pain before menstruation, it may change general state women, which is accompanied by the appearance of several of the most common signs:

• Emotional lability - on the eve of menstruation in a woman without visible reasons mood can change dramatically. ordinary, calm state replaced by irritability, tearfulness. Relatively drastic changes may occur several times during the day. Sometimes a stable depressed mood is possible, accompanied by drowsiness.
• An increase in body temperature to subfebrile numbers (up to + 37.5 ° C), which is accompanied by chills.
• General weakness, decreased ability to work.
• Changes functional state digestive system, which are accompanied by dry mouth, nausea, periodic, bloating (flatulence), as well as loosening of the stool.
• Decreased appetite, taste perversion.
• Dizziness of varying severity, headache, which does not have a clear localization. Sometimes at the height of the headache, the development of a semi-conscious state or fainting is possible.
• Unpleasant sensations, discomfort in the region of the heart, which may be accompanied by palpitations, pain in the form of tingling.
• Numbness of the skin, feeling of cold extremities. Sometimes itching may develop different localization on the body.
• Frequent urination.
• Aches, "flying" pains in the joints.

The appearance of most of the first signs of algomenorrhea is the result of a change in the functional state of the autonomic part of the nervous system. It accompanies the development of a large number of other diseases. On the possible presence in a woman, algomenorrhea indicates the cyclicity and connection of the first signs with menstrual cycle. They usually appear 1-2 days before menstrual bleeding.

Symptoms of algodismenoria

Main clinical manifestation Algodysmenorrhea is pain that has several characteristic features:

• The frequency of occurrence of pain - the pain appears a few hours before the onset of menstrual bleeding and continues until they stop.
• The cramping nature of the pain, which in most cases accompanies algomenorrhea. Somewhat less often, pain sensations can be pulling, stabbing, cutting, which is associated with the presence of concomitant disease or pathology that provoked the development of algomenorrhea.
• Localization.
• Irradiation of pain, it gives to the perineum, groin, inner surface thighs, rectum, lower back.
• Different intensity of pain, which may be small and not require therapeutic measures or very strong, unbearable, decrease only after taking or parenteral (subcutaneous, intramuscular, intravenous) administration of appropriate drugs.

During the entire period of menstrual bleeding, in addition to pain, other signs of the pathological process in the structures of the reproductive system may appear. These include a change in the volume of secretions (they can be "smeared" or very
voluminous, reminiscent of intense uterine bleeding), the appearance of pathological impurities in the form of mucus, blood clots. Since against the background of menstrual bleeding, the body undergoes hormonal changes, then algomenorrhea is almost always accompanied by signs of a change in the functional state of the autonomic nervous system. They usually appear first, even before the development of characteristic pain. Only a medical specialist can establish the fact of the development of algomenorrhea.

Causes and prevention of algodismenoria

Algodysmenorrhea is a polyetiological condition. This means that the development of the pathological process provokes a significant number of different factors. With a primary (essential) violation of menstruation, the following groups of causes are distinguished:

• Mechanical causes - difficulty in the exit of blood from the uterine cavity, due to various factors (excessive tilt of the uterine body forward, which is called anteflexio, pathological volumetric formations in the cervical canal).
• Hormonal factors - insufficient production of certain biologically active compounds in the brain, a violation of the functional state of the endometrium.
• Neuro-psychogenic causes - a reduced threshold of pain sensitivity, character traits, emotions.
• Constitutional features - a change in the shape of the uterus in girls who have an asthenic body structure.
• Hereditary changes that are laid down at the genetic level.

The development of secondary algomenorrhea in women is the result of the following pathological causative factors:

• Myoma (benign tumor originating from smooth muscle cells) of the uterus, localized in the cervical region. This leads to the fact that squeezing occurs, the lumen decreases and the outflow of blood is difficult.
• (dyshormonal immune pathology) - from the foci of atypical localization of the endometrium, a cyclic development of bleeding occurs, which causes the appearance of pain.
• Inflammatory processes that have a chronic course and are localized in various structures of the female reproductive system (oophoritis, formation of adhesions) and lead to displacement of the uterus with a deterioration in blood outflow.
• The use of an intrauterine device, which potentiates the increased production of prostaglandins, which irritate sensitive nerve endings and lead to pain.
• Allen-Masters syndrome, which is characterized by rupture of the ligaments that support the uterus after difficult childbirth, unsuccessful abortion.
• Malformations of the uterus (infection cervical canal, the presence of an additional horn, a bifurcation of the uterus), which lead to a violation of the outflow of blood.

Finding out the cause of the development of algomenorrhea is important diagnostic event. To prevent development pathological condition it is important to monitor the health of the reproductive system, to prevent chronic diseases, conduct regular sexual life with one sexual partner, avoid general or local hypothermia (do not be in a draft). When the first signs of the development of algomenorrhea appear, you should consult a doctor. Performing simple preventive measures will prevent not only the appearance of painful periods, but also other pathologies of the woman's reproductive system.

Treatment of algodismenoria

Before determining therapeutic measures, a diagnostic study is prescribed, which allows you to reliably determine the cause of the development of algomenorrhea. It includes a large number of various methods (ultrasound of the uterus, hysteroscopy, examination of the vagina and uterine cavity, laboratory research vaginal swab, urethra, neck), on the basis of the results of which the cause is established. Further treatment is complex and includes several areas of therapeutic measures:

• Etiotropic therapy is a treatment aimed at eliminating the further impact of the causative factor that led to algomenorrhea. Depending on the clarified cause, surgical intervention is performed (malformations, displacement of the uterus, fibroids), antibiotics are prescribed for an infectious cause of a chronic inflammatory process, hormonal medicines in case of installed .
• Pathogenetic and symptomatic therapy- the purpose of the measures is to reduce the severity of pain during menstruation. For this, nonsteroidal anti-inflammatory drugs are used that reduce the level of inflammatory mediators (,), antispasmodics that reduce tone smooth muscle( , ). Drugs are used only in case of sufficiently severe pain.

Against the background of essential primary algomenorrhea, lifelong medication may be necessary. Usually a woman takes the pills during her menstrual bleeding. Since non-steroidal anti-inflammatory drugs have Negative influence on the liver, it is important to follow a few rules while taking them:

• The duration of medication without interruption should not exceed 5 days.
• At a time, you can take no more than 2 tablets or powder (can be produced in bags with powder for dissolution in water).
• The daily dosage should not exceed 4-5 tablets or powders.

Long-term use of drugs in high therapeutic doses leads to the development of drug-induced hepatitis (inflammation of the liver caused by excessive functional load).

For the convenience of taking and reducing the burden on the liver and kidneys, the modern pharmacological market presents combined preparations, which in their composition contain a non-steroidal anti-inflammatory agent and an antispasmodic (Spazmalgin, Noshpalgin). Due to the combination, the therapeutic effect is achieved faster and a lower dosage of drugs is required.

The prognosis for essential primary algomenorrhea is favorable, the state of the reproductive system does not change. In the case of the development of painful periods of secondary origin, timely and adequate etiotropic treatment is required.

With the deterioration of health and pain in the lower abdomen during menstruation and a few days before its onset, many girls and women face.

Cyclical processes occurring in the body can provoke sleep problems, nervousness and other unpleasant symptoms. About what algomenorrhea is, how to cope with the problem and what is the reason for its appearance, is described in this publication.

What it is?

Algodysmenorrhea is a painful menstruation accompanied by a violation general well-being. The main symptom in the form of spastic or aching pains in the lower abdomen, general weakness, nausea, sweating, swelling and other manifestations are accompanied.

Algodysmenorrhea can develop against the background hormonal disruptions, diseases of the uterus and appendages, due to abortion and complicated childbirth. The choice of treatment depends on the factors that provoked the appearance of the problem.

Etiology of algomenorrhea

The occurrence of algomenorrhea is associated with increased production of prostaglandins and their release into the uterine cavity. This happens during the premenstrual period and during menstruation. As a result, spastic contractions of the uterus begin due to an increase in its activity. In this case, the nerve endings of the organ become more sensitive, and painful sensations appear.

In the etiology of algomenorrhea, the causes depend on its variety, which can be primary or secondary. In the first case, there are four groups of factors:

1. Endocrine, when pain is directly related to a violation of the production of prostaglandins.
2. Mechanical, in which the outflow of blood from the uterus is difficult due to wrong position or abnormal development of an organ.
3. Constitutional are due to hypoplasia of the uterus or insufficient development of its muscular elements.
4. Neuropsychogenic, when the threshold sensitivity of the nervous system is reduced.

The cause of secondary algomenorrhea is hormonal problems or gynecological diseases:

• uterine fibroids;
• inflammatory diseases;
• endometriosis;
• Malformations of the internal genital organs.

Less often, this type of dysmenorrhea is caused by the presence of an intrauterine device, after the removal of which the problem of painful periods disappears. Algodysmenorrhea often affects women who are prone to frequent stress or high physical activity.

Pain and other symptoms primary algomenorrhea not caused by pathologies of the genital area or other organs. Doctors associate it with a violation of neurohumoral regulation, the mental state of a woman.

For example, the psychogenic type of dysmenorrhea is often found among adolescent girls with a sensitive or hysterical personality type. Algodysmenorrhea of ​​the primary type is caused by a feeling of anxiety and fear that appears shortly before the onset of menstruation.

The main symptom of algomenorrhea is pain in the lower abdomen. It can spread to the groin and sacrum, accompanied by aching pain in the lower back.

With dysmenorrhea, not associated with gynecological or other pathologies, the pain syndrome appears 1-2 days before the onset of menstruation and continues for the first two days of bleeding. In this case, the intensity of pain can vary from mild to severe and vice versa.

Other symptoms of algomenorrhea of ​​both its varieties are as follows:

• general weakness and decreased performance;
• anxiety, mood swings;
• dizziness;
• stool disorders - diarrhea or constipation;
• headaches, sometimes migraine-like;
• dorsalgia (back pain);
• swelling of the face and limbs;
• increased sweating.

In gynecological diseases, the symptoms of algomenorrhea may become more pronounced over time as the underlying disease progresses.

Diagnostics

In the diagnosis of algomenorrhea, it is important to identify or exclude pathology that could provoke painful menstruation. To do this, use the following diagnostic methods:

• General and gynecological examinations Outwardly, a woman may look emaciated, pale, irritable and tired. With secondary dysmenorrhea, palpation on the chair reveals an increase in the uterus, infiltrates, inflamed areas, with no such changes in the primary.
• Laboratory tests of blood and urine in the case of secondary algomenorrhea show an increase in leukocytes, changes in hormone levels, or other indicators characteristic of infectious-inflammatory or other pathologies.
• Ultrasound reveals pathological changes internal genital organs, for example, the presence of a tumor, cysts, fibroids, inflammation of the appendages.
• MRI detects neoplasms; with primary dysmenorrhea, this method is not informative.
• Diagnostic laparoscopy is rarely performed and is indicated when previous treatment has failed.
• Hysteroscopy is performed with suspicion of adhesive formations in the uterine cavity.
• Encephalography is prescribed if severe headaches are present during menstruation and allows you to identify diseases of the central nervous system.

With algomenorrhea, treatment depends on the underlying cause of the problem. If it is endometriosis, inflammation of the ovaries or other pathologies, then the attending physician selects the appropriate drugs and healing procedures- antibiotics, anti-adhesions, vitamins, necessary physiotherapy methods.

After the elimination of the underlying disease, the symptoms of dysmenorrhea, as a rule, disappear.

In the treatment of painful periods, non-steroidal anti-inflammatory drugs are used, the action of which is aimed not only at relieving inflammation, but also at suppressing the production of prostaglandins, and therefore at overcoming pain.

They begin to be taken 3-4 days before the onset of menstruation and end 2-3 days after it. Examples of funds - Ibuprofen, Diclofenac, Piroxicam, Naproxen.

For the relief of pain, drugs that combine an antispasmodic and an analgesic are also effective - Trigan, Spazmalgon, Baralgin.

In medical treatment of algomenorrhea are also used:

• oral contraceptives (Ovidon, Marvelon, etc.) with the ineffectiveness of NSAIDs and analgesics;
• gestagens (progesterone, testosterone derivatives);
• sedatives;
• vitamins;
• antioxidants;
• tranquilizers are indicated for psychogenic algomenorrhea.

In the case of a severe pain syndrome, painkillers are administered intramuscularly or intravenously, supplementing the treatment with antihistamines and sedatives.

Non-drug methods:

• electrophoresis with novocaine, magnesium sulfate, trimecaine;
• phonophoresis;
• breathing exercises;
• acupuncture;
• shortwave diathermy;
• ultrasound;
• massage, manual therapy;
• diadynamic currents.

A tangible contribution to the fight against painful periods makes healthy eating, normalization of work and rest, elimination of stressful situations, moderate exercise, giving up bad habits, including addiction to coffee and smoking.

Algodismenorea code according to ICD10

AT international classification diseases each disease is assigned a number. Algodysmenorrhea in ICD10 has three codes:

• 94.4 - primary;
• 94.5 - secondary;
• 94.6 - unspecified.

Long-term regular soreness and poor health before and during menstruation is a reason to be examined by a gynecologist.

Timely diagnosis and treatment will not only alleviate the condition on critical days, but will also cure an existing and possibly serious disease.