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Dysmenorrhea (dysmenorrhea) is one of the most common gynecological symptoms. It refers to people who have lower abdominal pain, swelling, backache or another discomfort before and after menstruation or during menstruation, and the symptoms seriously affect the quality of life.


The occurrence of primary dysmenorrhea is mainly related to the increased prostaglandin content in the endometrium during menstruation. The main cause of dysmenorrhea when the content of PGF2α increases. The high content of PGF2α can cause excessive contraction of uterine smooth muscle, vasospasm, and dysmenorrhea due to uterine ischemia and hypoxia.

Increase of vasopressin, endogenous oxytocin and β-endorphin and other substances.

Mental and neurological factors.

Secondary pain is often caused by endometriosis and adenomyosis.

Clinical manifestations

Primary dysmenorrhea is more common in adolescence, often onset within 1 to 2 years after menarche. Pain in the lower abdomen is the main symptom that accompanies the regular episodes of the menstrual cycle. The symptoms of secondary dysmenorrhea are the same as those of primary dysmenorrhea, and secondary pain caused by endometriosis is often progressively worse.

The pain usually starts after menstrual cramps, and the earliest appears 12 hours before menstruation. The pain is the most severe on the first day of menstruation, and it is relieved after 2 to 3 days. The pain is often spastic. Generally not accompanied by abdominal muscle tension or rebound pain.

It may be accompanied by symptoms such as nausea, vomiting, diarrhea, dizziness, fatigue, etc. In severe cases, the complexion becomes pale and cold sweats occur.

General treatment

(1) Attach importance to psychotherapy to eliminate tension and worries.

(2) Adequate rest and sleep, regular and moderate exercise, and quit smoking.

(3) When the pain is unbearable, supplement with medication.

Medical treatment

(1) For dysmenorrhea caused by adenomyosis without fertility requirements, Mirena is the first choice.

(2) Oral contraceptives: suitable for women with dysmenorrhea who require contraception, with an effective rate of over 90%.

(3) Over-the-counter drugs: acetaminophen, acetaminophen plus pamabromide, ethylene salicylic acid (aspirin).


Sun Haiyan, Cao Yongxiao, Liu Jing, etc. Establishment of a mouse model of dysmenorrhea. "CNKI", 2002

Ji Bo, Ren Xiaoxuan, Zhao Yafang, etc. A review of research on the pathogenesis and prevention of primary dysmenorrhea. "VIP", 2008

Peng Chao, Zhou Yingfang, Liao Qinping. A study on the correlation between the intensity of dysmenorrhea and prostaglandins in patients with adenomyosis. 2006

Cao Yunxia. The pathogenesis and prevention of primary dysmenorrhea. "Chinese Journal of Practical Gynecology and Obstetrics", 2001

Wang Ping, Zhang Lanzhu. Sixty-six cases of primary dysmenorrhea treated with Siwu Decoction and Shixiao Powder. "Modern Journal of Integrated Traditional Chinese and Western Medicine", 2004

痛经 痛經


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