Dysmenorrhea refers to lower abdominal pain or other discomforts before, after or during menstruation. Clinically abdominal pain during menstruation starting
from menarche is called primary dysmenorrhea and abdominal pain during menstruation after the occurrence of menarche is called secondary dysmenorrhea. Dysmenorrhea usually occurs among women of 15 - 25 years among young women during adolescence, or the unmarried or the married without delivery of child. Serious dysmenorrhea may affect health.
Dysmenorrhea is usually caused by emotional factors,invasion of six exogenous pathogenic factors and stagnation of qi and blood; or by retention of blood in the uterus due to liver depression and qi stagnation resulting from emotional upsets; or by cold-dampness attacking the lower energizer and lodging in the uterus due to walking in water during menstruation or sitting on damp ground; or by constitutional deficiency of qi and blood, or consumption of qi and blood due to serious disease and prolonged illness; or by congenital defect or impairment of the liver and kidney, consumption of blood and malnutrition of the uterus due to multiparity and excessive sexual life.
Key points for diagnosis
(1) The main clinical symptom is lower abdominal pain during menstruation. It usually occurs 1 - 2 days before menstruation or after menstruation.
(2) The manifestations are paroxysmal spasmodic pain or distending pain in the lower abdomen; the pain may radiate to the lumbosacral region, anus, vagina or medial side of the leg. In serious cases there are pale complexion, cold sweating, cold hands and feet, nausea and vomiting, diarrhea or even syncope. In a few cases,dysmenorrhea may be accompanied by symptoms of irritation sign of bladder, such as frequent urination and urgent urination. The duration of pain lasts from 2 - 3 days. The pain usually reaches its peak on, the first day of menstruation and then gradually alleviates or disappears. In the cases of membraniform dysmenorrhea, patches of endometrium exfoliate. Pain may be relieved after the removal of endometrial patches. Functional dysmenorrhea will gradually alleviate with the increase of age and improve after marriage or delivery of child.
(3) Basic temperature detection usually indicates ovulation menstrual cycle. Gynecological examination can be done to see whether there are abnormal changes in the shape, location and texture of the uterus and whether there is thickening change of the appendage as well as whether there is mass and tenderness.
(4) Ultrasonic test, pelvic pneumography and peritoneoscopy are made to decide whether dysmenorrhea is functional or organic. Prostaglandin test of menses can suggest whether there is abnormal increase of prostaglandin
(5) Measures should be taken to differentiate dysmenorrhea from abdominal pain caused by extrauterine pregnancy, rupture of corpus luteum, torsion of ovarian cyst, acute pelvitis, acute cystitis, urinary stones, appendicitis, colitis and acute gastroenteritis, etc.