Primary algomenorrhea. Algodysmenorrhea - what is it? Symptoms and treatment of algomenorrhea. Painful periods: what to do

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 consultation with medical specialist. Early detection and treatment of pathological causes of algomenorrhea is the basis for preventing the development of possible complications.

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

What is "algodysmenorrhea"?

The term algomenorrhea defines a pathological condition that affects the reproductive system of a woman and is accompanied by painful periods. The mechanism of development (pathogenesis) of pain during menstrual bleeding 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).
• The development of the 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.

The implementation of each pathogenetic mechanism of the occurrence of pain depends on the main 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 when the first menstrual bleeding occurs.
• Secondary (symptomatic) algomenorrhea - a pathological condition develops in an 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 resumes. 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, a woman's mood can change dramatically for no apparent reason. The usual, calm state is 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 varying degrees severity, headache, which has no 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. The possible presence of algomenorrhea in a woman is indicated by the cyclicity and connection of the first signs with the menstrual cycle. They usually appear 1-2 days before menstrual bleeding.

Symptoms of algodismenoria

The main clinical manifestation of algomenorrhea is pain, which 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 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, 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 body of the uterus 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.
• Neuropsychogenic Causes – Lowered Threshold 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 neck. 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 chronic course and are localized in various structures of the female reproductive system (, oophoritis, formation of adhesions) and lead to a 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 of the cervical canal, the presence of an additional horn, 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, it is prescribed diagnostic study, which allows you to reliably determine the cause of the development of algomenorrhea. It includes a large number of various techniques(Ultrasound of the uterus, hysteroscopy, examination of the vagina and uterine cavity, laboratory examination of a smear from the vagina, urethra, cervix), based on 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 infectious cause chronic inflammatory process, hormonal drugs in case of established.
• 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 drug-induced hepatitis(inflammation of the liver caused by excessive functional load).

For the convenience of taking and reducing the load on the liver and kidneys, combined preparations are presented on the modern pharmacological market, which in their composition contain a non-steroidal anti-inflammatory agent and an antispasmodic (Spazmalgin, Noshpalgin). Through the combination therapeutic effect achieved faster and requires a smaller dosage of drugs.

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.

Quite a lot of women and girls are faced with such a diagnosis as algomenorrhea. This disease is manifested by the appearance of spasmodic or monotonous, pulling pains during the passage of menstruation.

Algodysmenorrhea - the appearance during menstruation of sharp cramping or aching pain in the lower abdomen, in the lumbar and sacral regions of the spine, accompanied by general malaise and a decrease in work capacity. They are caused various reasons. Timely determination of the root cause of the pathology and the conduct of high-quality therapy will allow a woman to avoid even more serious health problems in the future.

Primary algomenorrhea associated with the accumulation of prostaglandins in the uterus, leading to the development of ischemia and pain. It is often noted with sexual infantilism or pathological bending of the body of the uterus. The cause of secondary algomenorrhea is inflammatory diseases genital organs, uterine tumors, endometriosis, partial infection of the cervical canal, etc.

ICD-10 code

N94.6 Dysmenorrhea, unspecified

Causes of algomenorrhea

If a woman has painful periods, you should not dismiss such a problem. Pain is a signal from the body that a malfunction has occurred in its functioning, which must be immediately eliminated. Otherwise, further progression of the disease can lead to a complex pathology with the impossibility of regression.

The causes of algomenorrhea can be quite diverse:

• Endometriosis is a disease that mainly affects women of reproductive age. With this pathology, the cells of the inner layer of the walls of the uterus grow outside their layer.
• Myoma - formation benign neoplasm in the muscular layer of the female organ.
• Adenomyosis is a rather complex inflammatory process, as a result of which there is a focal fusion of two layers of tissues of the uterine walls: myometrium ( muscle tissue walls of the uterus) and endometrium (the inner lining of the uterus).
• Hyperretroflexia is the growth of segmental reflexes, which become more frequent due to a decrease in the inhibitory effect of the cerebral cortex on the segmental reflex apparatus.
• Hypoplasia of the uterus is a condition in which the size of the female organ is much smaller than the norm, due to its underdevelopment.
• The uterus is incorrectly located in the pelvic cavity, which leads to a failure in the waste mechanism menstrual blood from the uterine region.
• Violation of the integrity of the inner layer caused by trauma, abortion, difficult childbirth, surgery.
• The cause of algomenorrhea may also lie in an infectious and inflammatory disease that affects one or more organs of the reproductive system. These include, for example, salpingoophoritis (inflammation of the uterine appendages, fallopian tubes and ovaries), both acute and chronic forms.
• Physical inactivity, lack of physical activity can also cause pain symptoms.
• Diseases can provoke the development of pathology psychological nature caused by increased excitability of the patient's central nervous system: a tendency to tantrums and hypochondria.

Symptoms of algomenorrhea

This pathology is predominantly observed in women. childbearing age quite often in infertility. The disease can be either congenital or acquired. Symptoms vary depending on the type of disease.

In the case of congenital pathology, pain symptoms begin to appear even during the puberty of a girl, while acquired is a consequence of an operation, an infectious-inflammatory disease and other factors.

The symptoms of algomenorrhea are as follows:

• Sleep disturbance.
• Often, the pain begins to pester a woman a few days before the onset of menstruation and stops after the start or complete end of bleeding. Pains are pulling or cramping. Their appearance can be expected in the lower abdomen, in the region of the lower back and sacrum. Gradually, irradiation of pain can develop. The woman begins to feel that the pain begins to “radiate” to the intestines, in the perineum, to affect the inner thighs.
• Failures in metabolic processes.
• Dry mouth.
• Flatulence.
• Headaches, sometimes quite severe.
• Temporary disability.
• There may be increased secretion of fluid by sweat-producing glands.
• Nausea, sometimes turning into a vomiting reflex.
• Very low vitality.
• Symptoms of diarrhea may appear.
• Dizziness, possible fainting.
• Rarely enough, but bulimia and anorexia can be observed.
• An increase in body temperature to a figure of 37ºС.
• Exhaustion of the nervous system, which can be observed against the background of severe pain.

Primary algomenorrhea

Physicians distinguish between primary and secondary form diseases. Primary algomenorrhea - it is still diagnosed as a functional pathology, does not affect the violation of the anatomical structure female organs. It begins to appear even in young girls during puberty or a year and a half after the onset of menarche (menstrual cycle).

Whereas secondary algomenorrhea develops on the basis of anatomical changes caused by trauma or one of the diseases of the internal genital organs. With this pathology temperature indicators a woman's bodies can be substantial and accompanied pathological secretions from the vagina, which have a characteristic bad smell. In this case, the menstrual cycle can be knocked down, and the time blood secretions lengthen.

The considered pathology is divided into three types according to functionality:

• Spasmodic algomenorrhea, accompanied by spasms of a sufficiently high intensity (there is an intense contraction of the smooth muscles of the uterus).
• Essential algomenorrhea. Mostly it is a congenital pathology associated with very low threshold sensitivity in women.
• Psychogenic algodismenorrhea is diagnosed in most cases in an adult of the fair sex, if she suffers from any mental illness, or in a girl during puberty - this may be due to the fear of the first menstruation.

Symptoms of primary algodismenoria are similar to those listed above. Their complex is individual for each woman suffering from this pathology. To the already existing list, you can add:

• Hiccups.
• Drowsiness.
• Syndrome of "cotton legs".
• Possible swelling.
• Dislike of certain odors.
• Disgust for individual products nutrition.
• Numbness of the lower and / or upper limbs.
• Skin itching.

Pain in primary algomenorrhea has a cramping character. The predominant localization is down the abdomen and lumbar region, much less often it can be felt in inguinal region and in the area of ​​the external genitalia.

If a woman - a girl is concerned about these symptoms, accompanied by pain in the designated places, you should not postpone going to the doctor - gynecologist. It is he who is able to establish a diagnosis, attributing it to the primary or secondary pathology. But only by making the correct diagnosis, you can count on positive outcome treatment.

Can contribute to the development of algodismenoria early term the beginning of the menstrual cycle, failures in its course (a long period of blood discharge). Not last place in the appearance of this pathology, it also takes the presence of a woman bad habits: smoking, alcohol, physical inactivity. No matter how sad it sounds, but today the majority of women who have not yet given birth suffer, to one degree or another, from primary algomenorrhea. This fact is very frightening for physicians, because subsequently, if appropriate therapeutic measures are not taken in a timely manner, the progression of this pathology can become an obstacle to the desire of a young woman to become a mother.

Diagnosis of algomenorrhea

staging correct diagnosis- this is perhaps one of the key points in the treatment. After all, how correctly the cause of the disease is established, the prescribed therapy also depends. Incorrectly diagnosed, therefore, the wrong approach to treatment and, as a result, the patient, in best case, waiting not for a solution to his problem, but at worst - getting a complication from incorrectly prescribed medications.

Diagnosis of algomenorrhea includes the following studies:

• Questioning the patient about her complaints, and how long they bother her, and what symptoms accompany the pain during the passage of menstruation. Already at this stage qualified specialist able to make an assumption about the presence of a pathology of a certain orientation.
• Examination by a gynecologist.
• Identification of a gynecological history: the presence of specific diseases, hereditary predisposition. The doctor is trying to get information about whether the mother, grandmother of the patient suffered from this disease. How early the first menstruation passed, the presence of surgical interventions affecting the genitals and other organs of the small pelvis. Knowledge of the abundance of discharge during menstruation and the nature of pain symptoms are also essential.
• Ultrasound examination of the pelvic organs.
• Calposcopy or hysteroscopy diagnostic procedure, which allows you to visually examine the state of the entrance to the vagina, the mucous membrane of its walls and the cervix close to the vagina. The study takes place using a colposcope or, accordingly, a hysteroscope - a special medical device consisting of a binocular and an illuminating lamp.
• Polymerase chain reaction(PCR) is a high-precision information method of molecular genetic research. It makes it possible to identify various infectious and hereditary diseases(both acute and chronic).
• Taking a smear from the vagina, cervical canal and urethra. Microbiological research it to the flora.
• Establishing the level of hormones in the blood of a woman during the first and second phases physiological cycle women.
• Laparoscopy is a method of endoscopic surgery that allows you to examine the organs of the abdominal cavity.
• A consultation with a psychotherapist or psychologist is required.

Primarily, specialist studies are aimed at identifying secondary pathology, and only if the diagnosis of algomenorrhea made it possible to exclude it, the patient is diagnosed with primary algomenorrhea, which is essential for determining treatment methods.

It is unlikely that anyone will argue that timely and professional diagnostics is the key to effective therapy, and the basis of any treatment course.

Treatment of algomenorrhea

Treatment of secondary algomenorrhea is aimed, at the first stage, at eliminating the identified organic changes in the uterine cavity and small pelvis by hysteroscopy and laparoscopy methods (separation of adhesions, removal of endometriosis foci, correction of the incorrect position of the uterus, etc.), which can significantly reduce pain syndrome. At the second stage, if necessary, the application of methods is shown. conservative therapy used in the treatment of primary algomenorrhea (inhibitors of prostaglandin synthesis, progestin or combined estrogen-progestin drugs, antispasmodics, analgesics).

The diagnosis is made, and treatment can begin. If the disease is defined as a primary pathology, then the treatment of algomenorrhea begins with the attending physician - a gynecologist, usually with antispasmodics and hormonal drugs. For example, it can be buskopan, flexen, no-shpa, oki and many others.

An anesthetic drug that effectively relieves muscle spasms - Buscopan is prescribed for oral administration (orally). The recommended dosage for adult patients and children who are already six years old is three doses throughout the day, one to three tablets.

If the gynecologist has prescribed another method of drug administration - rectal, in this case, this drug is used in the form of suppositories, which are used by the same age category three times a day. Before use, the rectal suppository is removed from the sealed shell and brought in with a beveled edge. The duration of the course of treatment is controlled by the attending physician and, if necessary, can extend it.

Refusal to use this drug can be: angle-closure glaucoma diagnosed in a patient, pulmonary edema, myasthenia gravis (an autoimmune disease manifested by weakness and pathological fatigue of skeletal muscles). These are atherosclerosis that affected the capillaries of the brain, megacolon (a malformation described as an anatomical increase in the size of the colon), as well as individual intolerance to hyoscine-N-butyl bromides or other components in the composition of the drug.

No-shpa is attributed to the patient in the form of tablets or a solution for subcutaneous or intramuscular injections.

In the form of tablets, the medicine is used by the patient two to three times a day, 40 to 80 mg after the main meal. And in the form of injections of 2%, the drug is administered rather slowly two to three times throughout the day in an amount of 2 to 4 ml (for one injection).

Medicine has its contraindications. It:

• Arterial hypertension.
• Stable increase in blood pressure immediately before the onset of menstruation.
• Bronchial asthma.
• Pylorospasm is a spastic contraction of the muscles of the pyloric part of the stomach, causing difficulty in emptying it.
• Angina.
• Ulcerative manifestations on the mucosa of organs digestive tract.
• Colitis, including spastic nature.
• Cholelithiasis.

If a young girl does not have a regular sexual life, NSAID (non-steroidal anti-inflammatory drugs) drugs are usually prescribed, mainly selective inhibitors COX-2. These include: celebrex, celecoxib.

A highly selective cyclooxygenase-2 inhibitor, Celebrex is prescribed for use by a doctor twice a day at a dosage of 0.2 g.

It is recommended to take Celebrex twice a day, 0.2 g of the drug. In the case of a sufficiently high activity of muscle spasms, the attending physician may prescribe to the patient a single dose in an amount of 0.4 to 0.6 g of the drug. After removal acute pain, it is desirable to return to the recommended dosage of 0.2 g.

If a woman has a history of a problem with kidney function, the daily amount of the drug taken should be halved. At liver failure the recommended dosage of the drug should not be adjusted.

Celebrex contraindications include a tendency to allergic manifestations, hypersensitivity or complete intolerance to the components of this drug or sulfonamides. And also if a woman or a girl underwent surgery to install a coronary bypass graft or the fair sex is in the third trimester of pregnancy.

Non-selective NSAID drugs used in the treatment of algomenorrhea include faspic, ibuprofen, buran, nurofen, which show pronounced anti-inflammatory and analgesic characteristics.

The dosage of Ibuprofen is prescribed purely individually and depends on the level of manifestation of pain symptoms. Mostly for adult patients and girls who are already 12 years old, the doctor prescribes one to two tablets, administered three to four times a day, immediately after meals. In case of acute pain or a complex course of the disease, the attending physician may decide to increase the dosage: three tablets taken three to four times a day, which corresponds to the daily intake of ibuprofen ( active ingredient drug) in the amount of 1.8 - 2.4 g. The maximum daily dosage should not exceed 2.4 g.

Should not be taken this drug if a woman suffers from one of the following pathologies:

• Ulcerative and erosive lesion mucosa of the digestive tract.
• Bronchial asthma.
• Ulcerative colitis of a nonspecific form of manifestation.
• Leukopenia - a reduced number of leukocytes contained in the blood of a woman (less than 4000 in 1 μl of peripheral blood).
• thrombocytopenia.
• Dysfunction of the kidneys and / or liver in severe form.
• Hypertension.
• Dysfunction of the heart muscle.
• A disease that affects the optic nerve.
• Pregnancy and lactation.
• Hypersensitivity to non-steroidal anti-inflammatory drugs or other components of the drug.

Hormonal drugs are prescribed by a gynecologist depending on the age of the patient and whether she has a permanent sexual partner. If a woman regularly lives sexually, then she is mainly prescribed hormonal drugs that have the status contraceptives. The modern pharmacological market is represented by a wide range products of this category, but in the treatment of algomenorrhea, the advantage of prescribing belongs to low-dose oral contraceptives.

The third-generation drugs used in such a situation include mersilon, femoden, janine and others.

Method and schedule for taking microdosed ethinyl estradiol in combination with a progestogen chemical element can be found in any instructions attached to a hormonal contraceptive prescribed by a gynecologist.

For example, Jeanine is administered orally, washing down the dragee with a sufficient volume of water. Reception is carried out once a day in certain time which must be strictly adhered to. The duration of the treatment course is 21 days, after which it is kept for seven days without injection. Do not skip doses - this significantly reduces the effectiveness of treatment.

Jeanine is not prescribed for women with severe liver pathology, with hypersensitivity to any of the components of the drug, if the patient has thrombophlebitis or a tendency to thrombosis, diabetes, arterial hypertension, pancreatitis, a malignant neoplasm affecting the liver, bleeding affecting the reproductive system of a woman. Jeanine is also not taken during pregnancy or when a young mother is feeding her newborn baby.

In addition to the therapy described above, a woman suffering from algomenorrhea receives general strengthening therapy. Under these terms, the intake of vitamins is hidden (this especially applies to their B6 and E group affiliation), as well as minerals and trace elements. In this situation, the presence of magnesium ions is especially necessary.

If secondary algomenorrhea is diagnosed, then, depending on the primary source, it may be necessary to include in therapy surgical intervention conducted on the organs of the female reproductive system. The operation makes it possible to eliminate an anomaly in the structural structure of one of the reproductive organs. If the operation is performed, then immediately after its completion, the obstetrician-gynecologist prescribes antibiotics, and then others medications described above.

To get the fastest effect, in the protocol complex therapy connect and a number of physiotherapy. In this situation, electrophoresis performed on a woman in the second half of the menstrual cycle works great.

Drugs for algomenorrhea

The essence of any therapy is the elimination of the cause of the pathology or, in extreme cases, its symptomatic manifestation. To stop or reduce the intensity of pain, drugs for algomenorrhea are prescribed from the group of analgesics. For example, it can be sedal-M, pentalgin, ketonal, spasmol, efferalgan, baralgin M, analgin, panadol. With severe pain symptoms, complex medicines are suitable, for example, baralgetas, took, spazgan or pazmalgon.

If the cause of pathological pain in a woman is one of the diseases affecting the psychological area of ​​\u200b\u200bthe woman's health, which is caused by increased excitability of the central nervous system (a tendency to tantrums and hypochondria), tranquilizers are prescribed to such a patient. This category of drugs is designed to stabilize mental condition women. These drugs include: Valium, chlordiazepoxide, xanax, hydroxyzine, diazepam, clobazam, triazolam, lorazepam, alprazolam, librium, frisium, elenium, phenazepam, bromazepam, seduxen, atarax, relium, oxylidine.

The dosage of Diazepam (Diazepamum) is prescribed to patients individually and based on the severity of the diagnosed disease. The drug is taken twice a day. A single amount of the administered drug can be administered in the range of 4 to 15 mg. At the same time, the maximum allowable daily volume of the administered drug should not exceed 60 mg (and this dose is prescribed by the attending doctor only if the woman is in a hospital, so that it is possible to constantly monitor her condition).

If intramuscular or intravenous administration is necessary, the doctor prescribes injections or invasion with a volume of 10-20 mg of the drug.

It is strictly forbidden to introduce this drug into the treatment protocol if a woman is diagnosed with myasthenia gravis, liver and / or kidney dysfunction, angle-closure glaucoma, and also if the body shows increased intolerance to the constituent components of diazepam or the patient is pregnant.

If the person seeking advice adult woman has regular sexual intercourse, then, in order to stop the spasmodic pain that bothers her, and the accompanying symptoms, hormonal drugs classified as low-dose contraceptives are prescribed. It can be microgynon, yarina, novinet, logest, marvelon, belara, miranova, regulon, silest, triregol.

Yarin is administered orally in the form of a dragee, which is washed down with a sufficient volume of water. Reception is carried out once a day at a certain time, which must be strictly adhered to. The duration of the treatment course is 21 days, after which it is kept for seven days without injection. Do not skip doses - this significantly reduces the effectiveness of treatment.

This contraceptive is not prescribed for women with severe liver pathology, with hypersensitivity to any of the components of the drug, in case of arterial hypertension, diabetes mellitus, the patient has thrombophlebitis or a tendency to thrombosis, pancreatitis, a malignant neoplasm affecting the liver, bleeding affecting the female reproductive system . Yarina is not accepted during pregnancy or when a young mother is feeding her newborn baby.

But still, the preferred method of therapy is taking two to three days before the expected monthly inhibitors of the production of prostaglandin synthetase, which in medicine are combined into a group of non-steroidal anti-inflammatory drugs. This group includes: nifluril, kaksulindak, orthofen, ketazon, indomethacin, voltaren, ketoprofen, donalgin, revodin, mefenamic acid, metindol, butadione, surgam, reopyrin, pirabutol, piroxicam.

Mostly adult patients and girls who are already 14 years old, the doctor ascribes a single dosage that falls in the range from 0.25 to 0.5 g, taken three to four times throughout the day. The maximum daily dosage should not exceed 3.0 g. If the expected effect is achieved, then to maintain it at the required therapeutic level, it is enough to reduce the daily intake, bringing it to 1.0 g.

If premenstrual pains torment a girl under 14 years old who has already had her period, then mefenamic acid is taken at 0.25 g three to four times throughout the day. The recommended duration of treatment is from 20 to 45 days, and with medical indications and longer.

This drug should not be taken by women with a history of peptic ulcer stomach and duodenum, renal pathology, problems with hematopoiesis, diseases caused by inflammation in one of the organs of the digestive tract, as well as in case of individual intolerance to the components of the drug in question.

The main principle of such therapy is the prevention of the occurrence of pain symptoms. And if pain is still felt during the onset of menstruation, then, while taking inhibitors of prostaglandin reproduction, its intensity is significantly lower than without the introduction of such drugs.

With severe pain, drugs of the same group will be more effective, but combined action. These include veralgin, baralgin, spazgin, trigan, spazmalgin, maxigan, spazmalgon, minalgan.

Baralgin does not depend on the time of eating and is prescribed one - two tablets two - three times during the day. With very strong spasmodic pains, baralgin in the form of injections or invasions is administered slowly in an amount of 2–5 ml intravenously or intramuscularly. Treatment course usually three to four menstrual cycles.

Monogestagens also showed high efficiency of administration: norkolut, acetomepregenol, dydrogesterone, norethisterone, turinal, orgametril and dufaston. Preparations of this group are usually prescribed for admission, starting from the 14-16th day of the menstrual cycle to the 25th day. In this case, the drug is administered once a day, at the same time, with a dosage of 5 to 15 mg.

Remove from the diet foods that include stabilizers, dyes, preservatives and other chemicals.

Inattention to one's health is simply a crime against nature. After all, it would seem that such a harmless algomenorrhea, if ignored, can ultimately lead to infertility and deprive a woman of the chance to become a mother.

Forecast of algodismenorrhea

If the patient is diagnosed with a disease that belongs to the primary form of pathology, the prognosis of algomenorrhea is quite favorable. You just need to slightly adjust your lifestyle, nutrition and, if necessary, undergo a little therapy.

The situation with the treatment of secondary pathology is somewhat more complicated. If the patient turned to the local obstetrician-gynecologist in time, fully passed the examination and adequate treatment, then we can expect complete cure or at least reduce the intensity of pain manifestations. End result in this case significantly depends on the severity of the disease that causes such symptoms.

The main omen of a woman is the birth of a child. And if the symptoms described above begin to bother her, she should not be delayed with going to the doctor. Pain can talk about the development in the patient's body enough serious illness. There is only one conclusion. If a woman carefully fulfills all the requirements of her attending physician, then there are high chances to get rid of such a disease as algomenorrhea once and for all, as well as to fulfill the mission given to her by nature - the birth of a new person.

The main thing is to contact a specialist in time and in any case do not give up, your health, first of all, is in your hands.

It's important to know!

Hypermenstrual syndrome - an increase in the volume and duration of menstruation up to constant bleeding. The development of hypermenstrual syndrome can be associated with both delayed rejection of the thickened uterine mucosa against the background of a relative or absolute excess of estrogens, and delayed regeneration at the end of the next menstruation.

Description:

Pain during menstruation resulting from infantilism, improper position of the uterus, inflammatory processes in the genital organs, with endometriosis and other diseases, as well as with increased excitability of the central nervous system. It is observed usually in young women (often with infertility). The pain appears a few days before menstruation, is often very severe and is accompanied by headache, nausea, vomiting and dizziness. With the onset of menstruation, it goes away on its own.

Symptoms:

Cramping pains during the days of menstruation or a few days before it are localized in the lower abdomen, radiate to the lumbar region, less often to the region of the external genitalia, groin and thighs. The pains are paroxysmal and quite intense, accompanied by general weakness, nausea, vomiting, spastic headache, dizziness, fever up to 37ºС, dry mouth, bloating, fainting and other disorders. Sometimes the leading symptom becomes one that worries more than pain. Severe pain is debilitating nervous system, contribute to the development asthenic condition, reduce performance.

Causes of occurrence:

The cause of severe pain during menstruation is any disease, such as fibroma, and others. At the same time, alternative methods of treatment do not always work, it is necessary to turn to experienced specialist, that is, to a doctor who can accurately determine why you have severe pain during menstruation.
The second reason for painful menstruation is sometimes a lack of physical activity.

Treatment:

Treatment of algomenorrhea is to eliminate the causes that give rise to it. Analgesics and tranquilizers are used to relieve pain.
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 the early (preventive) administration of drugs 2–4 days before the onset of menstruation (pain) and for 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 drugs type of renalgan (baralgin, trigan, maxigan, minalgan, spazgin, spazmalgin, spasmalgon, veralgin), containing in its composition, 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 in case of insufficient effect or very strong menstrual pain("menstrual colic") 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 (combined oral contraceptives) are used.

The most effective drugs great content 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 used intramuscular injection progesterone 1% - 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 in the area inner surface forearm at a distance of 3 cm from the first injection. There are 3 courses in total. According to I. L. Luzina and L. P. Bakuleva, a good therapeutic effect in primary algomenorrhea 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.

Many women complain of pain during their periods. Moderate pain, lasting no more than two days, is considered the norm, but strong, severe attacks, in which it becomes impossible to lead a normal life, indicate algomenorrhea.

general information

Algodismenorrhea is a consequence of the incorrect location or abnormal structure of the uterus, its immaturity, the presence of foci of inflammation in the genital organs, endometriosis, and increased excitability of the central nervous system. This pathology is observed in women aged 14 to 45 years. Pain in algomenorrhea is pronounced, and often causes significant reduction quality of life and complete disability. That is why this problem should be considered not only in a medical, but also in a social context.

Classification and symptoms

There are two types of algomenorrhea:

1. Primary (or functional). Does not depend on anatomical structure internal genital organs.
2. Secondary. It develops as a result of pathologies of the organs of the genitourinary system.

Primary algomenorrhea appears immediately after a regular menstrual cycle is established. AT special group The risk includes excitable and emotionally unstable girls. The main symptoms inherent in primary algomenorrhea include:

• paroxysmal pains in the lower abdomen, extending to the lower back and the area of ​​​​the external genital organs;
• malaise, migraine;
• swelling and redness of the face;
• nausea, vomiting, bloating;
• frequent urge to urinate and defecate;
• increase in body temperature;
• irritability, insomnia, deterioration of memory and attention;
• dizziness and fainting.

Important! Discomfort begins to appear not only during menstruation, but also a few days before it begins. It happens that one of the above symptoms causes much more anxiety and inconvenience than the pain in the lower abdomen or lower back itself.

The secondary develops as a result pathological changes internal genital organs associated with past childbirth, abortion or inflammatory diseases. Signs of secondary algomenorrhea are similar to the primary ones, but there are some differences:

• vaginal discharge with a characteristic unpleasant odor is observed;
• pains make themselves felt throughout the cycle, and with the advent of menstruation intensify;
• menstruation becomes irregular, lasts longer, the amount of blood increases.

The reasons

Primary algomenorrhea is provoked by:

1. Incorrect location of the uterus, its underdevelopment, hypoplasia, conditions against which the free outflow of menstrual blood is hindered (infection of the hymen).
2. An excess of prostaglandins in the body - substances that contribute to the reduction of the myometrium (the muscular layer of the uterus). But nausea, tachycardia, headache and chills are also associated with excessive prostaglandins.
3. Emotional and psychological factors: dislike for oneself, rejection of one's own femininity, denial of one's sexuality.

The causes of secondary algomenorrhea include:

1. Endometriosis. In this case, pain during menstruation is associated with the process of exfoliation of the affected areas of the endometrium.
2. Myoma of the uterus. Since the resulting tumor does not allow menstrual blood to flow freely, muscle contractions become more intense, nerve fibers are irritated, and prostaglandins are released.
3. Chronic inflammatory diseases characterized by the formation of adhesions. For example, due to adhesive disease the location of the uterus changes and the normal outflow of blood is difficult. In addition, inflammation often causes swelling of the adjacent soft tissues, resulting in compression of the nerve fibers.
4. Spiral installation (exception - intrauterine contraceptives containing gestagens) and cleaning during abortion or after childbirth - such manipulations can be a trigger for the development of algomenorrhea.

Diagnostics

Diagnosis of algomenorrhea is based on the collection of anamnesis, laboratory, instrumental and other studies:

1. At the beginning, the specialist listens to complaints and finds out when the pains began, how long they lasted, and whether other symptoms bother you. The patient is obliged to inform the doctor about the number of births or the absence of them, to tell about previously undergone abortions and operations.
2. Then follows gynecological examination and taking swabs from the cervix, vagina, and urethra.
3. After that, an ultrasound, blood and urine tests are prescribed (sometimes it is required to establish the level of hormones and the presence of sexually transmitted diseases).
4. It is advisable to conduct CT and MRI of the pelvic organs, and in case of endometriosis, a hysteroscopic or laparoscopic examination should be performed.
5. In some cases, the patient may need to consult a urologist.

Treatment

Treatment of algomenorrhea is performed on an outpatient basis. But with painful periods, you can’t rely solely on painkillers! It is important here not only in a timely manner, but also a correct diagnosis, because pain can signal an extremely dangerous states requiring serious qualified assistance or emergency surgery.

Medical therapy

The main method of dealing with algomenorrhea is based on the use of special medications. The tactics of treatment should be selected taking into account the presence or absence of gynecological diseases, as well as the physiological characteristics of the patient's body. Most often, women suffering from this disorder are prescribed:

1. Non-steroidal anti-inflammatory drugs: Aspirin, Naproxen, Paracetamol, Ibuprofen.
2. Antispasmodics and analgesics: Spazmalgon, Analgin.
3. Estrogen-gestagenic drugs with high content gestagens (steroid female sex hormones): "Anteovin", "Lindinet", "Sinfaz".
4. Psycholeptics or sedatives: "Valerian", "Motherwort", "Mint", "Trioxazine".
5. Homeopathic substances: Menalgin, Remens.
6. Phonophoresis, electrophoresis, reflexology, vitamin therapy.

Important! influence the dynamics clinical picture and work with a psychologist or psychotherapist can improve the patient's condition.

Treatment with folk remedies

You can fight painful periods with the help of alternative ways, but before you start using folk remedies, you must definitely get the approval of a gynecologist! Here is a list of the most common and proven recipes:

1. Horsetail tincture. Pour the dried plant with alcohol in a ratio of 1: 2, insist for 1 week. Ten drops of tincture diluted in one tablespoon of water and consumed during menstruation once a day.
2. Melissa tea. It is recommended to start drinking 10 days after the end of menstruation.
3. Decoction of elecampane root. Pour one teaspoon of the crushed plant root with 250 ml of hot boiled water and leave for an hour. Strained broth take 1 tablespoon 4 times a day.

Prevention

Prevention of algomenorrhea is quite simple and does not require much effort from the patient. After treatment, experts advise:

• stop smoking, drinking alcohol, strong coffee;
• try to avoid stress;
• get enough sleep;
• normalize body weight;
• monitor nutrition;
• do sport;
• visit a gynecologist at least once every few months.

A timely visit to the doctor and the fulfillment of all medical prescriptions will not only make it easier to endure menstruation, but also guaranteed to protect against severe consequences, health threatening and life in general.

The body and body of the fairer sex undergo changes every month. Normally, after puberty and before the onset of menopause, a woman observes menstruation. It manifests itself as a small bleeding lasting from three to seven days. It is worth noting that most women experience various ailments during this period. This article will tell you about such a concept as algomenorrhea. What it is and what symptoms it has will be described below. You will find out the main reasons for this condition. It is also worth mentioning what kind of algomenorrhea treatment has in a particular case.

Description of pathology

Algodismenorrhea - what is it? If to speak plain language, then this condition is manifested by painful menstruation. In this case, the intensity of unpleasant sensations can be different. Doctors talk about such a thing as algomenorrhea, what is it functional disorder periodic cycle of the female body.

Medicine distinguishes primary and secondary forms of pathology. The intensity of the pain syndrome does not depend on the type of disorder. Primary dysmenorrhea can be attributed to functional deviations of a woman's condition during menstruation, which are not caused by any pathologies. The secondary manifestation of pain during menstruation occurs due to the addition of any abnormalities or diseases.

Primary algomenorrhea

What it is? This type has two main subspecies. Doctors distinguish psychogenic and essential disorders of menstruation.

The first subspecies is characterized by the fact that the representative of the weaker sex makes herself experience such suffering. At the same time, women have intense fear before painful sensations. The body, in turn, reacts accordingly.

Essential algomenorrhea is characterized by a decrease in pain threshold. It is because of this that a woman may feel unpleasant manifestations of menstruation. Experts say that in most cases this is the so-called feature of the body.

Secondary algomenorrhea

This type of pathology also has two subspecies. Doctors distinguish congenital and acquired algomenorrhea. The first type includes various anomalies in the structure of the uterus and appendages, which were formed during fetal development. Most often, symptoms begin to disturb a woman already with the onset of the first menstruation.

Acquired algomenorrhea occurs over time as a result of various pathological processes. These include inflammation, adenomyosis, endometritis, endometriosis, genital tract infections, and so on.

Symptoms of pathology

Depending on what causes algomenorrhea, its manifestations may be different. Absolutely always it is possible to allocate a pain syndrome. Unpleasant sensations can begin even a few days before the next bleeding. After a certain time, they intensify and cover the entire lower part abdominal cavity. Also, pain can be given to the coccyx or localized in the back. In addition to the main symptoms, the diagnosis of algomenorrhea can manifest itself as follows:

• psychological disorders and decreased libido;
• deterioration of the skin and hair;
• the occurrence of prolonged or prolonged spotting before and after menstruation;
• recurrent abdominal pain not associated with bleeding;
• headaches and migraines;
• weakness and loss of appetite (in some cases, anorexia);
• pain in the mammary glands and so on.

Sometimes women may notice an increase in body temperature during this period and problems with bowel movements. The last symptom may be diarrhea or constipation.

Is there a need for treatment?

Does such a pathology - algomenorrhea - require medical intervention and correction? ICD 10 describes this condition in some detail. Doctors say that it is not always required and it is possible to provide assistance to the patient.

Depending on the form and manifestation of symptoms, the method of treatment should be chosen. Primary algomenorrhea often cannot be corrected. Especially when it comes to its psychogenic form. Consider the main methods of treating this phenomenon.

The use of painkillers

In most cases, pain before menstruation and during them is stopped by women with analgesics. This method of correction becomes the most correct in the primary form of pathology. If the disease is caused by the fact that a woman has a lowered pain threshold, then it is simply impossible to treat it. It remains only to regularly, as necessary, take drugs such as Nurofen, Mig, Paracetamol, Nise, and so on.

Psychological correction and sedative medications

If before and during menstruation a woman experiences a strong fear of pain, then most likely she will appear. This is the result of a normal reaction of the body. It is worth noting that the treatment in this case is rather non-standard. Most often, a representative of the weaker sex is recommended to visit a psychotherapist. The doctor will be able to somewhat correct the worldview of a woman and free her from fears.

At the time of treatment, sedatives are always prescribed. These include "Persen", "Afobazol", motherwort tincture and many others. They must be taken strictly according to the instructions, taking into account the advice of a specialist.

Treatment of infections and inflammations

If the pathology is caused by infectious diseases of the uterine cavity and appendages, then most often antiviral, antimicrobial and immunomodulatory therapy is chosen. In this case, it is first necessary to conduct a series of studies and find out the sensitivity of certain microorganisms to the prescribed drugs.

In most cases, this correction positive results. A woman ceases to feel pain during the days of menstruation and begins to feel better. The cycle is also normalized and working capacity is restored.

Surgical intervention

This type of treatment is chosen when it comes to diseases such as endometriosis, polycystic ovary syndrome, anomaly in the development of the uterine cavity and its appendages. Also, the laparoscopic method can be used for diagnostic purposes with subsequent treatment. Most often this happens when doctors cannot establish the underlying cause of the disease, and conservative methods turn out to be powerless.

Laparoscopy is performed under general anesthesia or with the help of epidural anesthesia and takes from 10 to 90 minutes. Much depends on the severity of the disease. Most often, after the procedure, a woman must remain in the hospital for several more days. However, simple and quick manipulations allow the patient to be discharged within a few hours.

Treatment without medication

This type of correction in most cases is selected as an additional one. However, when implicitly severe symptoms may become the main one. It consists in maintaining a proper lifestyle and observing certain rules:

• A woman with pain during menstruation should limit physical activity. Do not provoke the body. If possible, take a vacation for a few days and just lie down.
• During this period, you need to be in a good mood. Treat yourself and try not to be nervous. Sleep well, walk more fresh air, watch your favorite movies.
• Limit your intake of caffeinated foods and milk. It is also worth at this time to exclude alcohol in any form. Sexual contact during this period is strictly prohibited.

Many women note that the symptoms and signs of algomenorrhea disappeared on their own after pregnancy and the subsequent birth of a child. At the same time, doctors cannot give a correct explanation for this fact.

Summarizing

Do you know what algomenorrhea is. Symptoms and treatments are described above. Many representatives of the weaker sex resort to folk methods corrections. Among them, one can note the use of decoctions of herbs for douching and ingestion. It is worth saying that doctors, obstetricians and gynecologists do not recommend acting in this way. Often this leads to an unexpected reaction. In case of complaints, contact the specialists and, after the necessary examination, receive the correct appointments. Be healthy!