Pain is a signal of problems in the body, and its location can tell a lot. Often in women, pain during menstruation radiates to the rectum. In this case, it is necessary to seek medical help to determine the cause of the pathology. Discomfort can be felt not only in the rectum, but also in the tailbone, back, and radiate to the thigh and lower abdomen. Gynecological diseases, intestinal disorders and other factors contribute to pain in the anus.
Inside the anus there are many nerve endings and vessels, which, under certain factors, are prone to inflammation and the formation of nodes. It is during menstruation that blood circulation in the pelvic organs increases, which leads to favorable conditions for the life of various pathogenic microorganisms.
Sedentary work, lack of an active lifestyle, hard physical labor and heavy lifting can cause the formation of intestinal pathology and pain in it.
If the pain is of a shooting nature, you need to determine the cause of its occurrence as soon as possible and consult a doctor for this. Any disease without treatment goes from acute to chronic, which complicates the situation.
Despite the fact that the pain appeared during menstruation, it can be associated with various infectious processes in the rectum, neoplasms or fissures, and not just with diseases of the female genital organs.
The rectum is anatomically located very close to the vagina; they are separated only by a thin septum. Almost every woman experiences slight discomfort during menstruation, which quickly passes after the discharge ends. But the presence of severe cramping pain that radiates to the anus should worry the woman and become a reason for a visit to the doctor.
Pain in the rectum during coccingodynia occurs periodically after defecation or is constantly present and can radiate to the female genital organs, tailbone, and thigh. A characteristic symptom of the disease is increased pain when pressing on the tailbone area.
The patient's gait is slightly disturbed, the butt may be very painful in a sitting position, constipation appears, and the mood worsens due to a constant feeling of discomfort in the anus. During menstruation, painful sensations may intensify.
Inflammation of the veins of the rectum, called hemorrhoids, occurs a little differently in women. When the menstrual cycle begins, complaints of pain in the anus become more frequent. The cause of pain is increased blood flow in the hemorrhoids during menstruation. In some women, hemorrhoids extending to the anus are accompanied by a slight burning sensation and bleeding. Typically, an exacerbation of the disease passes along with menstrual flow.
The inflammatory purulent process of the tissues around the rectum leads to a sharp deterioration of the condition, high temperature, and shooting pains in the anus. A dangerous abscess is located around the anus or inside in the muscle layer.
The onset of menstruation sometimes provokes the rapid development of the disease. Without proper treatment, the disease quickly progresses and leads to fistulas and purulent discharge mixed with blood.
Various damage to the rectal mucosa and trauma lead to anal fissure. Pain sensations depend on the depth of the crack, which can form due to paraproctitis, hemorrhoids and other inflammatory processes.
Pain, a feeling of heaviness and a burning sensation in the rectum during menstruation often appear due to cryptitis. This is an inflammation of blind pockets due to infection. The disease leads to constipation, the formation of fistulas, and sometimes the development of a malignant process. Severe pain increases even more with heavy lifting and defecation.
If the anus hurts during menstruation, the likelihood of gynecological diseases is high.
A common menstrual cycle disorder is expressed by cramping or nagging pain in the abdomen, lower back and rectum. General weakness, headache, nausea, and stool disturbances often accompany algodismenorrhea.
The disease can be primary or secondary due to other pathological processes in the body. Among the causes of this pathology are endometriosis, endometritis, abnormal position of the uterus, bending of the cervix and other diseases.
A benign formation in the uterus is called fibroids and often causes pain in the rectum, stomach, and bleeding. The tumor most often occurs in women after 35 years of age. The degree of pain and its location depend on the size of the tumor. One of the characteristic symptoms of uterine fibroids is impaired menstruation. Causes of fibroids:
Inflammation of the uterine appendages quite often becomes the reason why the rectum hurts in women during menstruation. Other symptoms include a sharp increase in temperature, severe pain in the sacrum and lower abdomen, muscle pain, and increased sweating. The inflammatory process occurs due to the penetration of streptococci, E. coli, gonococci, the installation of an intrauterine device, and due to sexually transmitted diseases.
A severe gynecological disease also causes pain in the anus. Endometrial cells grow and penetrate neighboring organs, which provokes pain during menstruation, when blood circulation in the pelvic organs increases.
The menstrual cycle is disrupted, and blood accumulates and is not excreted. A woman has spotting vaginal discharge that may not stop for a month.
Pain in the lower abdomen, fever, and pain in the anus almost always accompany an ectopic pregnancy, which requires urgent medical attention.
Mandatory examination includes:
If an infectious nature of the disease is suspected, a general blood and urine test is prescribed. To exclude intestinal pathologies, sigmoidoscopy and colonoscopy are performed. A mandatory diagnostic method is a patient's stool analysis and bacteriological blood test.
You cannot expect the pain to go away on its own, even if it is not too intense. For each disease, medical care is different.
General recommendations for the prevention of diseases of the pelvic organs boil down to the following rules:
If pain during menstruation radiates to the rectum, you should definitely visit a doctor. Such pain does not always mean problems with the digestive tract. They may be a sign of serious pathologies of the female genital organs that require urgent treatment. By paying attention to pain radiating to the rectum, you can stop the development of the pathological process.
Leg pain often bothers women during pregnancy, which is caused by natural changes in the body. Sometimes pain occurs during menstruation, during menopause, and persists for some time after childbirth. Often these phenomena are temporary and are not considered a pathology, but sometimes they are a symptom of chronic diseases of the lower extremities.
Pregnancy is a huge burden on a woman’s body, resulting in temporary pain symptoms that usually go away after childbirth. Pain in the legs is felt more intensely in later stages due to increased load on the musculoskeletal system. The appearance of pain, as a rule, occurs against the background of a chronic inflammatory process in the joints, aggravated during pregnancy.
Leg pain associated with menstruation is common for many women. Substances produced by the body during this period, identical in their chemical composition to hormones, cause very strong contractions of the uterus. Pain during menstruation can accompany various infections of the reproductive system in women.
During menopause, the female body experiences complete hormonal changes, which is a considerable stress; there is often a lack of certain minerals and trace elements, such as calcium - all this provokes pain in the legs. The development of osteoporosis during menopause is facilitated by increased bone fragility due to a lack of hormones. Menopausal arthritis is another potential cause of leg pain.
Postpartum leg pain is mainly associated with severe stretching or rupture of ligaments, muscles, and tendons during childbirth.
Pregnant women periodically report pain in the legs of various types, caused by calcium deficiency in the body. Because of this, the contractility of muscle tissue is impaired, which can cause spontaneous, fleeting cramps and spasms, usually at night and in the last months of pregnancy. High levels of progesterone in the blood also contribute to the occurrence of seizures. An increase in pressure on the lower extremities leads to disruption of venous circulation, which also provokes pain. Varicose veins often accompany pregnancy. If spider veins or capillary hemorrhages appear on your legs, it is best to consult your gynecologist.
The presence of excess fluid in a pregnant woman’s body is often the cause of swelling and throbbing pain in the lower extremities.
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If you regularly experience pain in your legs during your period, you should not neglect consulting a doctor. Typically, the cause of a painful symptom is an increased level of hormones, which leads to disruption of the venous outflow of blood. Swelling of the lower extremities is often observed.
Pain in the legs is observed in almost all women during menopause, which is due to natural changes in the body. Most often it is aching and constant in nature and is highly dependent on the vagaries of nature.
Postpartum stretching of the pelvic floor muscles and spine is accompanied by pain in the lower back, spreading to the legs, and weakness in the legs. The vertebrae, weakened by the influence of hormones, press on each other more than usual and cause attacks of pain, and the need to lift a child in your arms and something heavy can cause an exacerbation of existing spinal diseases.
The most acceptable diagnostic method is a thorough history taking, external examination and anthropological measurements of the pregnant woman. In this way, the physiological causes of pain can be identified. The presence of chronic diseases that could worsen during pregnancy is important.
A blood test for hormones and the presence of pathogenic microflora is often prescribed for pain in the legs during menstruation. Postpartum pain most often goes away over time. Women during menopause also suffer from pain in the legs of various types, which only a doctor can determine.
Pregnant women are advised to especially strictly monitor their weight and monitor the appearance of edema. Proper, rational and balanced nutrition is the prevention of leg pain. Exercise therapy and regular walking have a very positive effect on the body of a pregnant woman.
A gynecologist will tell you which medications are indicated to alleviate the condition and for therapeutic purposes.
Many women and girls complain of severe pain during menstruation. The intensity varies: from minor discomfort to unbearable burning pain, accompanied by fainting, vomiting, dizziness, headache, pain in the legs.
It is important to promptly identify the provoking factors of such a disorder and help alleviate the condition. It is worth understanding that regulation is a natural process in the female body. But if it is dysmenorrhea, then the outcome of pain during menstruation may be extremely unfavorable.
Severe pain during menstruation can be:
Other types of menstrual pain with the onset of menstruation include:
On a note! To get rid of back and lower back pain, just take an antispasmodic, a comfortable position and apply heat (a heating pad). You can get rid of pain in the nipples with the arrival of your period by taking a contrast shower and performing a relaxing massage with circular movements of your palms.
Most often, pain during menstruation is caused by increased production of the hormone progesterone. This is a harmless phenomenon when the glandular tissue additionally increases in volume. The main thing is to take timely measures to make you feel better.
The main cause of pain during periods in teenage girls is primary algomenorrhea or a condition that can last up to 3 years until the menstrual cycle returns to normal. Girls additionally note:
Other causes of pain during menstruation in girls:
With congenital pathologies in the structure of the uterus and fallopian tubes, an increased level of serotonin is observed in the cerebrospinal fluid. Girls suffer from low body temperature, gastrointestinal disorders, diarrhea, swelling on the face, and allergies.
The cause of pain during regulation in women after 30 years is secondary algomenorrhea. It occurs with moderate (severe) severity, often leading to aggravating symptoms:
Women suffering from diabetes experience disorders of the endocrine system, and with the approach of menopause, a depressive state, an unstable psycho-emotional background, and pain in the uterus during sexual intercourse appear.
IMPORTANT! Such signs cannot be ignored, regardless of the root cause that led to painful periods. It is necessary to immediately visit a gynecologist and undergo the proposed examination.
The causes of secondary algomenorrhea can be severely pathological. Can call:
Painful menstruation can result from:
On a note! Minor pain with the arrival of menstruation is considered normal. So, the uterus is activated and begins to contract vigorously, pushing out exfoliated particles of the mucous membrane. A hormone-like prostaglandin also acts, leading to pain, the degree of manifestation of which directly depends on the concentration of this hormone in the blood.
Carrying out drug treatment with the onset of painful periods is a last resort. You should not take pills thoughtlessly. This may cause addiction and additional side effects.
If pain during menstruation does not bother you much, then it is enough to take an antispasmodic, 1 tablet of No-shpa, Spazmalgon, Analgin to relieve spasms. It is better to avoid strong drugs (Ketanov, Aspirin). Dosages should not be neglected when taking painkillers. It is recommended to take 1 pill first and wait a little time. If relief does not follow, you can take 1 more tablet.
On a note! It is not enough to take medications for menstrual pain with 1-2 sips of water. To make you feel better and quickly dissolve the tablet form of the drug, you need to drink at least 1 glass of liquid.
If medications become unsuccessful in relieving pain during menstrual periods, then you can take a non-steroidal anti-inflammatory analgesic (Dicycloverine, Drotaverine, Spazmalgon). In severe cases, it is permissible to take Nimesulide or Ibuprofen. Hormonal contraceptives help quite well with manifestations of dysmenorrhea. However, treatment should be carried out under the supervision of specialists, since even minor interference with hormonal levels can result in serious disorders of the reproductive system.
IMPORTANT! If the pain during menstruation only intensifies, what should you do when it does not stop for 3-4 days in a row? It is better to consult a doctor immediately. You should also be wary of the passage of large blood clots with an unpleasant odor, increased discharge on the 2nd day of menstruation with the appearance of severe pain in the lower abdomen, increased temperature, burning, and itching when urinating.
As an alternative, if there is no effect from taking painkillers, you can use:
Physical exercise is recommended for women with painful periods to maintain the muscles of the uterus in tone. Of course, there is no need to exercise intensely. It is enough to choose an easy sport that is acceptable to you and pay attention to it for 15-20 minutes every day.
It is appropriate to simply walk more often at a brisk pace to normalize general well-being with the onset of menstruation; yoga, taking comfortable statistical positions with the body remaining at rest, without sudden movements, can be useful. This does not use the necessary muscles, but it increases endurance and level of physical fitness, tidies up the muscles of the abs, peritoneum, and pelvic floor.
It is useful to master breathing exercises that help relax the pelvic muscles, relieve spasms in the uterus, and relieve painful contractions. It is recommended to combine breathing exercises with regular physical exercises in order to direct actions to relax the muscles of the uterus and minimize menstrual pain.
To relieve pain during menstruation, herbal teas, infusions of valerian, motherwort, chamomile, cloves, cinnamon, raspberries, oregano, boron uterus, nettle, and lemon balm containing phytoestrogens will help. Here are some good recipes:
Herbal infusions are quite effective, have no side effects and are pleasant to the taste. It is useful to brew dry raspberry leaves, mint, chamomile, lemon balm and drink as tea.
REFERENCE! Painful periods should not be confused with PMS, which may coincide with the onset of menorrhagia. Also, abnormal uterine bleeding can be caused by fibroids in the uterus.
It is not true when they say that heat applied to the abdomen during painful periods increases bleeding. Of course, using a very hot heating pad is not recommended. But heat for 10-15 minutes is quite appropriate to eliminate pain.
On a note! You should not take a hot bath on menstrual periods, so as not to provoke the development of diseases. Ice and applying too cold compresses to the abdomen are also prohibited in order to avoid the development of inflammation and hypothermia of the ovaries.
Massaging painful areas in the lumbar region by rolling a ball (tennis) will help minimize pain. You can lie on it with your back or manually knead your lower abdomen without pressing with all your force to avoid aggravating the problem.
Acupressure helps with pre-menstrual pain by pressing on functional active points of the body to make you feel better. The following techniques can be used:
Essential oils (aran, nutmeg, sage, yarrow, St. John's wort) help by rubbing into the sacrum area, lower abdomen 2-3 days before menstruation and in the first days. It is useful to go swimming, which will help release endorphins (a natural analgesic) and relax muscles.
IMPORTANT! If you have painful menstruation, you should not drink alcohol, which will only lead to increased bleeding.
Menstruation is a normal, natural physiological phenomenon in the life of every woman. To eliminate pain, it is important to identify the triggering causes.
Doctors do not recommend enduring pain, in particular, regularly taking analgesics, NSAIDs, and addictive painkillers. For girls with primary amenorrhea, it is recommended:
Women with secondary algomenorrhea should undergo laparoscopy, ultrasound, and diagnostic curettage. In everyday life, it is advisable to keep a diary, track the amount of discharge, the duration of the menstrual cycle, the severity of pain, and the presence of other unpleasant symptoms. Healthy:
If you suspect an inflammatory process in the body, you should immediately see a doctor.
To prevent painful periods, women are advised to:
If the pain during menstruation has become prolonged, cramping and painful, led to nervousness, irritability, and other unpleasant sensations in the chest, and disrupted the usual way of life, then doctors say that such manifestations cannot be ignored. You need to undergo treatment, undergo tests, undergo an ultrasound and examination by highly specialized doctors.
The main thing is to promptly identify the true causes of painful menstrual bleeding so that treatment becomes as effective as possible.
In a normally functioning female body, cyclical changes occur against the background of hormonal changes. Thus, in the body of representatives of the fair sex, a follicle matures, an egg is released from it during the period of ovulation and then, in anticipation of fertilization, moves through the fallopian tubes, and in the absence of conception, it is rejected along with the inner uterine layer. This process takes place in three stages.
The follicular phase begins with the arrival of menstruation. During this period of time, many women note a maximum deterioration in their general condition: nervousness, headaches, pain in the lower abdomen and lumbar region, stool disorders. For the most part, these manifestations are not too intense and by the time the discharge ends, on days 4-5, they completely disappear. And in the ovaries the stage of maturation of a new follicle begins and it lasts two weeks.
This is followed by a short period, only three to four days, when the egg ready for fertilization leaves the follicle (ovulation). During this period of the cycle, the probability of pregnancy is maximum. As for pain during this period, it can be short-lived and located in the lower abdomen, on the side of the ovary that released the egg. If the pain is severe and accompanied by bloody discharge, loss of consciousness or persistent dizziness, ovarian rupture may be suspected. During the same period, changes begin in the mammary glands. They enlarge, become sore, and the nipples become excessively sensitive.
In the next period of the menstrual cycle (luteal phase), the inner layer of the uterus undergoes the greatest changes - it prepares to “meet” the fertilized egg, and in the absence of conception, its reverse development begins. The duration of this phase is about 15-16 days. And a week before the start of menstruation, a woman begins to feel signs that bleeding is imminent. Chest pain increases, there is increased irritability, headaches, nausea, pain in the lower abdomen and lower back, genitals, and frequent bowel movements. The last day or two before the onset of menstruation and the first days of bleeding in most women are considered “critical”, when the strength of the manifestation of all symptoms reaches its maximum, but is generally not too intense. Although there are cases, they account for no more than ten percent, when a woman during her period cannot lead her usual lifestyle due to pain. In some countries, it is normal practice to issue sick leave to women during this period.
This condition of excessive pain during menstruation is called algomenorrhea. Most often, it is accompanied by menstrual irregularities and symptoms that are not related to the sexual sphere, but indicate a hormonal imbalance in the body of the fairer sex, which entails disruptions in the functioning of other vital organs and systems.
To choose the optimal treatment tactics for algomenorrhea, you should understand the reasons for its occurrence.
Primary algomenorrhea is observed in young girls during the formation of the menstrual cycle (the first three years after the onset of menstruation) or in women who have not given birth after thirty years. It may be a sign:
Secondary algomenorrhea is observed in women with a history of childbirth and is caused by reasons that need correction and may indicate:
There are three degrees of intensity of algodismenorrhea: mild, moderate and severe.
Many women who suffer from increased pain during menstruation consider this to be harmless and make do with taking antispasmodic and analgesic tablets, in the hope that after pregnancy and childbirth everything will work out on its own.
Indeed, a single dose of such drugs, adherence to a plant-based diet, normalization of work and rest, maintaining physical fitness through regular exercises to strengthen the abdominal and pelvic muscles, applying heat to the abdominal area, stopping smoking and drinking alcoholic beverages, preventing hypothermia, avoiding stressful situations - all these measures can significantly reduce pain during periods of mild to moderate severity, but will not remove the causes of their occurrence.
To help the gynecologist select diagnostic methods, a woman complaining of excessive painful menstruation should keep a diary of observations of the menstrual cycle. Where indicators such as cycle duration, duration of bleeding, its intensity, as well as accompanying symptoms will be noted.
To find out the cause of severe pain during menstruation, the doctor at the first stage must conduct an initial gynecological examination and an intracavitary ultrasound examination of the pelvic organs. This will reveal the volumetric formations of these organs or their abnormal location. General clinical parameters of blood and urine are not very informative in this case, but may indicate inflammatory processes. The laparoscopic method is used for diagnostic purposes in cases of suspected rupture of the uterine ligaments or varicose veins of the small pelvis.
It is mandatory to carry out a cytological examination of cells from the surface of the cervix and cervical canal, colposcopy, if necessary, a biopsy from areas suspicious for cancer, curettage of the uterine cavity, and analysis of the amount of hormones. It may be necessary to involve other specialists (endocrinologist, neurologist) in the treatment.
Treatment of algodismenorrhea includes pain relief and treatment of the disease that caused it. It can be very difficult to determine the cause of primary algodismenorrhea, so therapy for painful periods of this type is reduced to taking antispasmodic drugs, non-steroidal anti-inflammatory substances and analgesics in the form of tablets or suppositories. A good analgesic effect is achieved using physiotherapeutic methods: acupuncture, electrophoresis. Taking sedatives will enhance their effect. In the absence of inflammatory diseases of the genital area, intramuscular injections of progesterone are prescribed, which helps relax the muscles of the uterus. If a woman is sexually active, you can consider prescribing hormonal contraceptives, which suppress ovulation and weaken uterine contractions. Surgical treatment is considered for congenital anomalies of the female genital organs.
Treatment of secondary algodismenorrhea much more often includes surgical methods. Surgical intervention is indicated for adhesions, cicatricial changes in the uterus, and neoplasms. Priority is given to laparoscopic and organ-preserving operations.
Menstrual pain is a cyclic painful sensation of varying intensity that accompanies menstruation. Not entirely pleasant subjective sensations accompany menstrual bleeding in almost every woman, but not all of them are classified as pathological. These include menstrual pain in the lower abdomen.
In the majority (80%) of women, the period of active uterine bleeding is accompanied by moderate pain, when a pulling or aching sensation appears in the lower abdomen. They do not distort the usual rhythm of life, do not require medication correction, last very short time (usually 2-3 days) and go away on their own. In addition, in healthy women, moderately painful menstruation does not recur from cycle to cycle, but is temporary, episodic, and occurs without accompanying pathological symptoms.
Feelings of pain and discomfort during menstruation are explained by contraction of the uterine muscles. When blood and fragments of exfoliated endometrium accumulate in the uterus, there is a need to quickly empty the uterine cavity of them. The uterine wall begins to intensively contract rhythmically, and its contents are evacuated, and unpleasant subjective sensations may appear in the projection of the uterus. The more the muscles of the uterus contract, the higher the likelihood of pain.
There is an opinion that menstrual pain is a consequence of an increase in the concentration of prostaglandins in the endometrium and blood plasma. Prostaglandins are complex chemical compounds that have pronounced biological activity and affect energy metabolism. They stimulate and enhance the contractile function of the myometrium during childbirth. With high concentrations of prostaglandins, the uterus contracts too intensely during menstruation, causing disruption of the blood supply to certain areas of the myometrium and, as a result, severe menstrual pain.
Before discussing changes in menstrual parameters, it is first necessary to determine which menstruation is considered “normal.” For most women, the concept of “normal” is consistent with regular menstrual bleeding with an interval of 25-35 days, which lasts no longer than seven and no less than two days. Physiological menstruation should not be too scanty (less than 40 ml) or excessively abundant (more than 150 ml). Blood loss, as a rule, is distributed unevenly throughout menstruation: the most “heavy” are the first 2-3 days, and then the amount of blood lost gradually decreases. It is the “heavy days” that most often pass with menstrual pain; much less often, women feel pain throughout the entire menstrual bleeding.
For convenience, patients are asked to measure menstrual blood loss by the number of sanitary pads changed per day. With physiological blood loss, a woman uses no more than 4 pads daily.
Normal menstruation allows for moderate menstrual pain in the lower abdomen, which does not prevent a woman from leading her usual life. Severe menstrual pain always signals trouble and requires a detailed clinical examination. However, it should be noted that the perception of pain in women is not equal and depends on the individual pain threshold. Therefore, complaints of painful periods cannot serve as the basis for a reliable diagnosis without an additional detailed search for their causes.
If menstrual pain does not always signal pathology, then which of them should you pay special attention to:
— Menstrual pain should certainly be on the alert for menstrual disorders, which include dysfunctional uterine bleeding, menorrhagia (heavy periods with a clear periodicity), metrorrhagia (irregular bleeding without established time intervals), polymenorrhea (frequent menstruation), intermenstrual bleeding and others.
— If menstruation is accompanied, in addition to pain, severe fever, deterioration in general health, and the appearance of a large number of dark clots in the menstrual blood, the cause of painful periods is often an acute inflammatory process in the pelvic cavity. As a rule, the intensity of pain against the background of inflammation tends to increase, the pain continues throughout the menstrual period, and sometimes does not stop after its end.
— The appearance of severe menstrual pain against the background of a delay often makes one think about a possible interrupted pregnancy (including an ectopic one).
— The pathological cause of pain during menstruation is indicated by its appearance before the onset of menstrual bleeding.
- The seriousness of the causes of painful periods is indicated by their constant nature, when menstrual pain that occurs (as it seems, without obvious serious reasons) begins to recur monthly.
Diagnosis of the causes of menstrual pain begins with a study of complaints and a gynecological examination. Sometimes the cause of pain is established already at the initial stage of the examination, when the patient clearly indicates a provoking situation: exacerbation of chronic inflammation, severe stress, excessive physical activity the day before or during menstrual bleeding, and others.
Laboratory diagnostics helps to exclude the infectious nature of menstrual pain, determine the state of hormonal levels, and instrumental examination methods (ultrasound, MRI, CT, hysteroscopy and the like) are required for a more in-depth search.
It should be noted that pain during menstruation is not always associated with pathological processes in the genitals. If an examination of organic pathology of the genitals is not diagnosed, painful periods are correlated with a physiological process based on disruption of the neuroendocrine, metabolic and psycho-emotional systems.
Treatment of menstrual pain should always be consistent with its cause. Relieving menstrual pain does not mean curing it, so therapy uses not only painkillers for menstrual pain. It is necessary to influence the cause of the disease and prevent its worsening.
Sometimes painful periods happen due to completely harmless reasons. For example, menstrual pain can appear as a result of an improperly organized lifestyle during menstruation, when patients overexert themselves physically: lifting weights, playing sports, and also doing work involving significant physical activity. Hypothermia and colds, stress and significant psycho-emotional stress can increase pain during menstruation. As a rule, painful periods that arise for these reasons occur only once, respond well to self-administered remedies for menstrual pain and do not recur.
A diagnostically important criterion is the time of occurrence of painful menstruation. Conventionally, all menstrual pain is classified according to the moment of appearance into primary and secondary.
Primary menstrual pain appears very early - during the period of the first menstruation (menarche) or no later than a year and a half later. When examining girls with primary menstrual pain, pathological abnormalities in the genital organs are not detected, but a large number of so-called “systemic” symptoms are always diagnosed, associated with functional disorders in the work of other (non-genital) systems of the body - nervous, endocrine, psycho-emotional, and so on. .
The most common causes of primary menstrual pain are:
— Endocrine disruptions leading to hormonal dysfunction and distortion of the proper secretion of prostaglandins.
— Mechanical obstacles to the timely evacuation of the contents of the uterine cavity during menstrual bleeding. These, first of all, include congenital malformations of the genitals: incorrect position of the uterus or its abnormal structure, partial or complete fusion (atresia) of the cervical cavity.
— Constitutional features, namely sexual infantilism, due to which the muscles of the uterus remain in an underdeveloped state and are not able to properly empty the uterus during menstruation.
- Psycho-emotional. Severe stress, prolonged emotional experiences and depression can change the proper functioning of the brain, including the centers regulating the menstrual cycle. Stress can also change the perception of pain by changing its threshold.
Sometimes the source of primary menstrual pain remains unclear. If, upon examination of a patient with primary menstrual pain, no organic or functional pathology is revealed, menstrual pain is considered an individual norm and correlated with a low pain threshold.
Thus, primary menstrual pain, according to the cause of its occurrence, can be classified into psychogenic (excessive lability of the nervous system and/or astheno-vegetative syndrome), spasmogenic (impaired ability of the myometrium to contract correctly) and essential (individual variant of the norm).
Menstrual pain of secondary origin appears against the background of gynecological diseases, which are their cause. Painful periods can be accompanied by infectious and inflammatory diseases of the genital area, fibroids and uterine polyps, endometriosis, adhesions and other ailments associated with organic changes in the organs of the pelvic cavity. Sometimes secondary menstrual pain is caused by an intrauterine device.
Primary menstrual pain manifests itself from the first menstruation or appears in the first year and a half after its onset. More often they appear in girls and women of asthenic physique, with low body weight and a labile psyche.
Painful menstruation of secondary origin appears in women 30-40 years old with gynecological pathology, with a history of childbirth, abortion, prolonged infertility, chronic infectious diseases and surgical interventions.
Among the complaints of patients, pain is most often mentioned. Typically, pain appears 12 hours before the start of the next menstruation and gradually increases towards the beginning of menstrual bleeding, but its duration is not always the same. As a rule, primary menstrual pain is most pronounced in the first 2 to 42 hours of menstrual bleeding, and then becomes insignificant or disappears altogether. The intensity of pain is also not the same. The pain can be aching, bursting, pressing, or it can acquire more vivid features - become cramping, sharp, and radiate to adjacent areas and organs.
It is customary to distinguish several degrees of pain syndrome manifestation:
— The first, easiest, degree is characterized by minor pain without accompanying negative systemic symptoms. Usually there is a slight pulling, aching or pressing sensation for a short time, equal to the period of heavy menstrual bleeding. The patient feels well and continues to lead an active life without taking pills for menstrual pain, but over time the pain syndrome may worsen.
- The second, moderate, degree of severity of menstrual pain is characterized by a more vivid clinical picture. The pain recurs every menstruation and is accompanied by other, systemic, pathological symptoms, and in the case of secondary pain, the patient develops signs of the underlying disease. This degree of severity of pain during menstruation can no longer be ignored, as it worsens well-being and does not allow one to lead a normal life. The patient always has to take pain medication for second-degree menstrual pain. An important diagnostic criterion that allows us to differentiate this degree of pain syndrome from others is the rapid relief of menstrual pain with medications.
— The third degree of menstrual pain can be called very severe. Pelvic pain is so severe that it makes it impossible for the patient to get out of bed. Systemic symptoms are more intense. No self-administered medications for third-degree menstrual pain alleviate the patient’s condition.
The cause of menstrual pain is not always obvious; finding it often requires a large list of diagnostic measures. They are carried out until the origins of the pain are discovered.
The examination begins with a study of complaints, a general and gynecological examination. Most often, patients with menstrual pain are young (under 30 years old), have a specific constitution, emotional lability and an “exhausted” appearance.
In adolescents, the leading complaints are primary menstrual pain due to menstrual irregularities in combination with premenstrual syndrome.
Systemic disorders accompanying menstrual pain of any origin are conventionally classified into:
— Autonomic: migraine-type headaches, heart rhythm disturbances, heart pain, alternating chills and excessive sweating, digestive tract dysfunction, vomiting, swelling of the face and limbs, weight gain on the eve of menstruation, fluctuations in blood pressure, fainting and many others.
— Psycho-emotional: shortness of breath or suffocation, “lump in the throat,” frequent unmotivated mood swings, poor sleep, apathy, anxiety and loss of appetite.
Secondary menstrual pain is always combined with symptoms of the gynecological disease that caused it. The most common causes of painful menstruation of secondary origin are:
- Endometriosis. This complex hormonal-dependent pathology provokes the appearance of pain several (5-7) days before the onset of menstruation. As a rule, in addition to pain, spotting dark discharge also appears. Pain with endometriosis continues even after menstrual bleeding ends. Often they subside only towards the middle of the cycle.
- Uterine fibroids. Myomatous nodes formed in the thickness of the uterine wall disrupt the contractility of the myometrium, provoking cramping menstrual pain.
— Inflammatory diseases and their main complication is the adhesive process. Adhesions change the position and mobility of the pelvic organs. During the adhesive process, the pain syndrome is not limited only to the period of menstruation, the pain is constant, and only intensifies during menstrual bleeding.
When studying the patient's complaints, it is important to find out what medications she takes for menstrual pain and how effective they are.
Laboratory diagnosis is most important for secondary menstrual pain. If they are caused by an infectious process, the results of a study of the microbial composition of the vaginal discharge and cervical canal (smear, culture, etc.) help determine the “culprit” of the inflammation.
Also, as part of a laboratory study, the level of main hormones (LH, FSH, estrogens, progesterone and others) is determined.
All patients with menstrual pain undergo an ultrasound scan of the pelvic cavity. It allows you to determine the condition of the uterus and appendages, detect pathological formations (cysts, fibroids, polyps, foci of endometriosis, etc.) and study the condition of the endometrium.
To diagnose the cause of primary menstrual pain, the help of related specialists is often required: endocrinologists, neurologists, therapists and others.
If the pain during menstruation does not change, they are considered compensated, and if they progress from cycle to cycle, becoming more pronounced and prolonged, they speak of decompensated menstrual pain.
It should be emphasized once again that if menstrual pain was limited to only one menstruation, and the subsequent periods passed as usual, the situation is physiological and does not require detailed examination and treatment.
Secondary menstrual pain is never treated in isolation from the underlying disease, because painful periods go away only after adequate treatment of the disease that caused them. Any pain reliever for menstrual pain is integrated into the therapeutic regimen, and the main therapeutic measures are aimed at their cause.
It is not easy to treat primary menstrual pain, since they do not have an organic basis, but are associated with systemic disorders. Therapeutic tactics depend on the severity of menstrual pain. The first, mild, degree without accompanying serious systemic failures can be cured without the use of medications. Mild menstrual pain goes away on its own after changing lifestyle, nutrition and reducing the load on the nervous system. To prevent the development of autonomic and metabolic disorders, it is sometimes recommended to take antioxidants, in particular vitamin E.
Since excessive synthesis of prostaglandins plays a significant role in the development of pain syndrome, it is necessary to eliminate it to relieve attacks of menstrual pain. This task is successfully accomplished by a group of non-steroidal anti-inflammatory drugs: Aspirin, Nimesulide, Diclofenac, Ibuprofen and the like. They can be used in different dosage forms - suppositories or tablets.
Medicinal suppositories for menstrual pain are very popular among patients because of their ease of use and quick therapeutic effect. They may contain antibacterial, antispasmodic and anti-inflammatory components that enhance the analgesic effect.
When choosing a treatment method for menstrual pain, the state of the body's hormonal function is always taken into account. Often, patients with menstrual pain are diagnosed with hormonal dysfunction, and hormonal drugs are used to eliminate it. Hormonal pills for menstrual pain are selected taking into account the level of estrogen.
Self-medication of this condition is unacceptable. Pills or suppositories chosen at random for menstrual pain may temporarily eliminate the pain, but are unable to eliminate their cause.