Life

Algomenorrhea what is it

Pin
Send
Share
Send
Send


Speaking in technical terms, a woman is a rather complicated mechanism. If there is a problem with any body, then it will pull a lot of others.

Female genital organs are a very complex system, so you need to pay attention even to the little things, because they sometimes play a key role. Ignoring gynecological diseases can lead to infertility.

Very often during menstruation a woman experiences discomfort. Of course, there is nothing pleasant in menstruation, but some women experience severe pain. This disease is called algomenorrhea.

The cause of the painful sensations most often becomes the incorrect position of the uterus, or its very small size, endometriosis, and inflammation of the reproductive organs can also affect the pain.

As a rule, the disease has several symptoms - it is pain in the abdomen, head, nausea, dizziness. All symptoms disappear as menstruation begins.

Algomenorrhea has two types - primary and secondary. Usually the primary is not associated with anatomy, it appears in girls with the very first menstruation. Although there are times when it appears in women. The pain is very strong, so no analgesics or tranquilizers can not do. By her character, she reminds of contractions, who gave birth, he will understand - how much it hurts!

Secondary algomenorrhea, unfortunately, is usually a manifestation of another disease. As a rule, it is a symptom of fibroids or uterine antiflexion, inflammatory processes. Sometimes this disease occurs after a difficult childbirth, or abortion.

ICD-10 codes

N94.0 Pain in the middle of the menstrual cycle,
N94.1 Dyspareunia,
N94.2 Vaginismus
N94.3 Premenstrual tension syndrome,
N94.4 Primary dysmenorrhea,
N94.5 Secondary dysmenorrhea,
N94.6 Dysmenorrhea, unspecified
N94.8 Other specified conditions associated with the female genital organs and menstrual cycle
N94.9 Unspecified conditions associated with the female genital organs and menstrual cycle.

Treatment

It is believed that secondary algodysmenorrhea will pass if the main disease is cured, as it is a symptom. However, terrible pain should not endure. It is necessary to apply anti-inflammatory drugs a couple of days before menstruation. You can also try medicinal fees, physiotherapy apparatus. Primary algomenorrhea most often passes after the first birth, up to this point a woman takes analgesics and anti-inflammatory drugs.

In any case, the help of an experienced gynecologist is a must! When it comes to gynecological problems, self-treatment can lead to infertility, which is a terrible diagnosis for any woman. Therefore, it is better not to risk without reason!

What is algodysmenorrhea: code for ICB 10

The diagnosis of dysmenorrhea can be made on the basis of the results of a comprehensive clinical and laboratory examination, which allows to exclude various causes of lower abdominal pain that are not associated with menstruation.

Clinical and anamnestic features allow you to specify the time of occurrence, the duration of pain, the cyclical nature of pain, the relationship of their occurrence with the menstrual cycle. Revealed a directly proportional dependence of the severity of dysmenorrhea on the social status, nature and working conditions. When interviewing patients, it is possible to identify familial cases of dysmenorrhea - the presence of dysmenorrhea in the mother or in the immediate family.

PHYSICAL SURVEY

The study of the autonomic status and psychoemotional characteristics of the patient helps to determine the different types of response to pain in different girls (it is necessary to evaluate the vegetative status of the patient: sympathetic, parasympathetic, mixed)

  • The predominance of sympathetic autonomic tone. The girls complain not only of pain, but also of an intense headache like migraine, nausea, fever with chills or internal tremors, feeling hot, sweating and the appearance of red spots on the neck in the form of a "vascular necklace", pain in the heart and palpitations, general weakness and dizziness, disruption of the bowels (intestinal colic due to spasm of arterioles and constipation) and increased urination (due to relaxation of the expulsion muscle). Pallor of the skin and acrocyanosis, dilated pupils are noted, sympathoadrenal crises are possible. Frequent sleep disturbances, including insomnia. A change in mood is characterized by internal tension and anxiety, uncertainty, obsessive fears, pessimism, up to and including the development of depression.
  • The predominance of the parasympathetic type of response to menstrual pain. At the time of an attack of pain in girls, vomiting and increased salivation, decreased heart rate, increased chilliness and pallor of the skin, asthma attacks, and seizures and fainting are possible, especially in stuffy rooms. Patients complain of a noticeable increase in body weight on the eve of menstruation, swelling of the face and extremities, the appearance of itching or allergic reactions, bloating and diarrhea. They note a decrease in body temperature and blood pressure, decreased performance, drowsiness, constriction of the pupils, the appearance of passive defensive behavioral reactions.
  • Mixed vegetative emotional reactions detected in most modern girls. The most difficult menstruation occur in asthenized girls with psychopathic personality traits. Neurovegetative manifestations in this group of patients also have mixed features: shortness of breath and aerophagia, asthma attacks ("lump in the throat"), weakness, decrease in body temperature and instability of blood pressure, increased fatigue, pain in the heart and headaches, aggravated during the painful, debilitating an attack of dysmenorrhea. Asthenization of the central nervous system is manifested by hypochondria, touchiness and tearfulness, bouts of irritability and aggressiveness, alternating depression and apathy, feelings of anxiety and fear, disturbances of the depth and duration of sleep, intolerance to sound, olfactory and, in some cases, taste stimuli.

Objective research. Characterized by multiple manifestations of connective tissue dysplasia.

  • Changes in the skin:
    —Vascular networks on the chest, back, limbs due to thin skin,
    —Increased skin stretchability (painless delay of 2-3 cm in the area of ​​the back of the hand, forehead),
    —Hemorrhagic manifestations (ecchymosis and petechiae during “pinch” or “tourniquet” tests),
    - intradermal breaks and stretch bands (stretch marks),
    —The symptom of “tissue paper” (remaining on the places of abrasions, wounds, chicken pox areas of shiny, atrophied
    skin).
    On examination, in addition, varicose veins are detected (functional insufficiency of valves, violation
    blood flow).
  • Skeletal abnormalities, the most frequent in girls with dysmenorrhea:
    —Dolamichenoma (lengthening and refinement of the limbs),
    - chest deformations (funnel-shaped, keeled),
    —Pathology of the spine (scoliosis, kyphosis, lordosis, flat back),
    - Pathology of the limbs (arachnodactyly, hypermobility of the joints, curvature of the limbs, flatfoot).
  • Symptoms of magnesium deficiency, damage to the visceral organs:
    —Diffuse abdominal pain due to gastrointestinal cramps,
    - Nausea, vomiting, heartburn,
    —Caps, alternating diarrhea,
    —Decreasing insulin production by the pancreas and increasing the risk of diabetes mellitus,
    —Laringo and bronchospasm,
    —Spastic uterine contractions.

LABORATORY-INSTRUMENTAL RESEARCH METHODS

In the management of patients with dysmenorrhea, diagnostic techniques that allow to recognize a disease, the mask of which was painful menstruation, acquire a great clinical significance.

The first among these techniques is the test with NSAIDs that have an antiprostaglandin effect. To help the doctor offers a wide range of drugs of a similar mechanism of action: acetylsalicylic acid, indomethacin, ibuprofen, naproxen, diclofenac, ketoprofen, piroxicam, and their analogues.

Scheme of the sample. The patient is offered to independently assess the severity of pain by a 4-point system against the background of a 5-day NSAID regimen, where 0 points is the absence and 3 points is the maximum severity of pain. For a more accurate assessment of pain on the scale of the anesthetic effect of NSAIDs, decimal values ​​are provided. It is not forbidden to use the classic visually analog scale with the distribution of divisions from 0 to 10 points.

The first, initial values ​​on the scale of intensity of pain, the patient is asked to fix when the appearance of highly annoying, but still tolerable pain, close to the maximum of the scale. The dynamics of the change in pain on the first day of the test are evaluated 30, 60, 120 and 180 minutes after taking the first pill, and then every 3 hours before taking the next pill before sleep. In the next 4 days, the patient is offered to take the drug on 1 tablet 3 times a day, assessing the severity of pain once in the morning. Medical evaluation of the analgesic effect of the drug should be carried out immediately, i.e. on the 6th day of the test. Along with the consistent filling of the pain scale, patients are offered to simultaneously fix the tolerability of the drug and the peculiarities of the vegetative-neurotic and psycho-emotional manifestations of dysmenorrhea.

  • The rapid decrease in the severity of pain and concomitant manifestations of dysmenorrhea in the first 3 hours after taking the drug while maintaining a positive effect on the following days allows us to determine with a high degree of certainty that the cause of dysmenorrhea is functional hyperprosaglandinemia.
  • Saving, and in some cases, increased pain, despite continued NSAIDs, on day 2–3, heavy menstruation, followed by a decrease in their intensity by the 5th day of the test, is more characteristic of patients with dysmenorrhea caused by endometriosis of the genitals.
  • In cases where, after taking the first pill, the girl indicated a regular decrease in the intensity of pain, and with further testing, she noted that painful sensations remained until the end of the drug intake, it can be assumed that PID is the main cause of dysmenorrhea.
  • The absence of the analgesic effect of NSAIDs throughout the entire sample, including after the first pill, suggests the insufficiency or exhaustion of the analgesic components of the nociception system. A similar condition is observed with genital malformations associated with impaired outflow of menstrual flow, as well as with dysmenorrhea caused by impaired leukotriene or endorphins.

Gynecological examination and the taking of bacteriological material eliminates the infectious factor as a possible cause of chronic inflammatory processes in the pelvic organs and, accordingly, one of the variants of secondary dysmenorrhea.

Ultrasound of the heart and the determination of the level of serum magnesium. Given that more than half of patients with dysmenorrhea show stigmas of congenital connective tissue dysplasia caused by a deficiency of intracellular magnesium (scoliosis, mitral valve prolapse, myopia, chest deformity), it is advisable to include girls with ultrasound dysmenorrhea and determination of serum magnesium levels in the examination complex. According to the available data, in 70% of patients with pubertal dysmenorrhea, severe hypomagnesemia is detected.

Determination of estrogen and progesterone in the days preceding the expected menstruation (23-25th days with a 28-day menstrual cycle). A comparison of the parameters studied allows us to identify important patterns in the development of dysmenorrhea in girls.

  • In patients with a mild degree of dysmenorrhea, the steroid profile is usually characterized by a normal ratio of estradiol and progesterone, and the response feature of the autonomic nervous system is a mixed variant of the vegetative support. Electroencephalographic data in such patients indicate a predominance of cerebral changes with signs of dysfunction of the mesodiencephalic and striopallidar brain structures.
  • In patients with dysmenorrhea of ​​moderate severity, the steroid profile is more often characterized by the classic version of NLF, normal estradiol production, which is not compensated by the corresponding effect of progesterone in the second phase of the menstrual cycle. In this group, as a rule, patients with multiple manifestations of the overactive sympathetic tone of the autonomic nervous system prevail. The electroencephalogram of patients reflects cerebral changes with signs of dysfunction of the mid-brain structures.
  • In patients with severe dysmenorrhea, estradiol levels are higher than normal, while the progesterone levels can meet the standards of the luteal phase of the menstrual cycle. In such patients in the clinic of dysmenorrhea, in addition to pain, signs of the parasympathetic influence of the autonomic nervous system predominate, which are manifested on the electroencephalogram of cerebral changes with signs of dysfunction of the brain stem structures.

Analysis of the test results, supplemented by knowledge of the electrophysiological state of the brain (electroencephalography) and the peculiarities of vegetative neurotic and psycho-emotional reactions, allow the doctor to decide on the type of therapeutic effect and provide a sufficiently lasting positive effect on the treatment of dysmenorrhea on an outpatient basis.

Laparoscopy and hysteroscopy should be carried out only according to the indications and in the hospital (if you suspect the presence of internal or external endometriosis, endometrial polyp, intrauterine synechiae, to clarify the status of internal genital organs with a long history of PIDI in history).

DIFFERENTIAL DIAGNOSTICS

  • Dysmenorrhea can be one of the earliest symptoms of malformations of the uterus and vagina, accompanied by unilateral delay in the outflow of menstrual blood (closed extra uterine horn or closed vagina). The characteristic signs of the latter are the onset of dysmenorrhea with menarche, a progressive increase in pain both in severity and in duration, with a maximum of their intensity in 6–12 months, the preservation of the same localization and irradiation of pain from month to month.
  • Dysmenorrhea can be caused by congenital insufficiency of the vascular system of the pelvic organs, better known as pelvic varicose veins or ovarian vein syndrome.
  • One of the rare causes of dysmenorrhea is a defect in the posterior leaflet of the broad ligament of the uterus (Allen-Masters syndrome).
  • A common cause of dysmenorrhea is endometriosis. In case of external endometriosis (peritoneum of the uterine rectal cavity, posterior leaves of the wide uterine ligaments, sacral ligaments, intestinal loops), the pain is aching, often radiating to the sacrum and rectum. Often the attacks are very strong.
    pain is accompanied by the development of the picture of "acute abdomen", nausea, vomiting and short-term loss of consciousness. Adenomyosis is characterized by a change in the shape and position of the uterus: the body of the uterus acquires a spherical shape with a diffuse form of adenomyosis and an irregular form with a nodular one. In endometriosis of the uterus, pain usually occurs 5–7 days prior to menstruation, increases in intensity by the 2-3rd day, and then gradually decreases in intensity by the middle of the cycle. In addition, the progression of profusion of menstruation is noted. The presence of endometriosis can be suspected in girls who have sex with partners, among which complaints dyspareunia is present - a pathognomonic sign of this disease. Endometriosis is also characterized by a slight rise in body temperature during menstruation, an increase in ESR.
  • Dysmenorrhea due to PID of nonspecific and tuberculous etiology has significantly different
    traits
    - In chronic salpingitis of non-tuberculous etiology, a pain of a whining or pulling character occurs 1-3 days before the menstruation and increases in the first 2-3 days of the menstruation. In inflammatory processes, the tension of adhesions formed between the peritoneal cover of the uterus and adjacent organs is important. Inflammation, starting in one of the departments of the genital tract, spreads to other areas. As a result, various combinations of such forms as salpingo-oophoritis, endometritis, tubo-ovarian formations, pelviocellulitis, pelvioperitonitis are possible. When inflammation of the internal genital organs are found, both microorganisms that cause STIs (gonococcus, chlamydia, ureaplasma, mycoplasma) and representatives of the usual vaginal microflora are detected.
    - For dysmenorrhea due to chronic genital tuberculosis, the following features are more specific. Prior general malaise, increased attacks of aching unmotivated abdominal pain without clear localization, especially in the spring or autumn season, painful menstruation with menarche. Disruption of the menstrual cycle, due to the property of tuberculous toxins affecting regulatory sex centers, neutralize sex hormones, and also cause atresia of immature follicles. Violations are most often of the type of hypo, opsomenorrhea, amenorrhea, metrorrhagia.
  • Дисменорею необходимо дифференцировать: с острым аппендицитом, перекрутом кисты яичника, апоплексией яичника, различной патологией толстого кишечника.
    - In favor of an acute appendicitis, characteristic signs will be indicated (lack of communication with the menstrual cycle, gradual increase in pain, signs of peritoneal irritation, often increased body temperature, leukocytosis, absence of uterus pain during recto-abdominal examination).
    - A condition called appendicular-genital syndrome is also often accompanied by dysmenorrhea. It is believed that every third girl, together with acute appendicitis, is diagnosed with OVDPM, most often catarrhal salpingitis, less often with perioophoritis and suppurative salpingitis, more rarely with oophoritis. Thus, in 33% of cases of appendicitis, there are prerequisites for the formation of the appendicular genital syndrome.
    - For torsion of ovarian cysts and for ovarian apoplexy, there are characteristic diagnostic features that allow you to make a diagnosis as soon as possible.

EXAMPLE OF FORMULATION OF DIAGNOSIS

Primary dysmenorrhea I (mild) or II (moderate) or III (severe) severity.
Secondary dysmenorrhea I (mild) or II (moderate) or III (severe) severity. Endometriosis of the ovaries and pelvic peritoneum or inflammatory disease of the pelvic organs (specific or nonspecific etiology) or
Chronic pelvic insufficiency.
Dysmenorrhea, unspecified.

AIMS OF TREATMENT

  • Elimination of pronounced pain syndrome.
  • Normalization of the state of the autonomic nervous system and the psychoemotional status of the patient.
  • Elimination or relief of symptoms of the main organic causes of dysmenorrhea (internal genital
    endometriosis, acute and chronic PID).
  • Normalization of the menstrual cycle (with a broken rhythm or with NLF).

NON-MEDICAL TREATMENT

Compliance with the regime of work and wakefulness, the regulation of the diet with an increase in consumption in the perimenstrual days of easily digestible and vitamin-rich foods and the elimination of products based on milk and coffee, an increase in the overall tone of the exercises of therapeutic and healthy gymnastics.
Perhaps the use of individual or collective psychotherapy. Proved a good effect on exposure to trigger points (acupuncture, acupuncture, magnetic therapy). Reflexology is more effective in combination with exercise therapy, diet, psychotherapy.

In the treatment of dysmenorrhea, the use of preformed medical and physical factors remains urgent: diadynamic therapy, fluctuation, amplipulse therapy.

SURGERY

Surgical treatment of girls with dysmenorrhea should be carried out in hospitals with endoscopic surgical unit. Laparoscopy is indicated for patients with the following pathology:

  • Persistent, non-conservative treatment of dysmenorrhea (to clarify the cause of the disease).
  • External genital endometriosis, including endometrial ovarian cysts.
  • Malformations of the uterus and vagina (additional rudimentary horn of the uterus, doubling of the uterus with aplasia of one of the vaginas).

FUTURE FACILITY

In the first year it is advisable to dynamic observation 1 time in 3 months. In the future, with a favorable course of the disease, it is desirable to conduct a follow-up examination 1 time in 6 months until the age of majority (18 years), after which the girl with a detailed statement of the results of the dynamic examination and treatment is transferred under the supervision of doctors providing obstetric and gynecological care to adult women.

Table Drug therapy for dysmenorrhea

Etiology of algomenorrhea

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

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

  1. Endocrine, when pain is directly related to impaired prostaglandin production.
  2. Mechanical, in which outflow of blood from the uterus is difficult due to improper position or abnormal development of the organ.
  3. Constitutional due to hypoplasia of the uterus or the lack of development of its muscular elements.
  4. Neuropsychogenic, when the threshold sensitivity of the nervous system is reduced.

The cause of secondary algodysmenorrhea are hormonal problems or gynecological diseases:

  • Uterine fibroids,
  • inflammatory diseases,
  • Endometriosis,
  • Malformations of the internal genital organs.

Less commonly, this type of dysmenorrhea is caused by the presence of an intrauterine device, after which the problem of painful menstruation disappears. Algodysmenorrhea often affects women exposed to frequent stress or high physical exertion.

Primary Algomenorrhea

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

For example, the psychogenic type of dysmenorrhea is often found among teenage girls with a sensitive or hysteroid type of personality. Algodysmenorea primary type is caused by a feeling of anxiety and fear, appearing shortly before the onset of menstruation.

Symptoms of Algomenorrhea

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

With dysmenorrhea, not related to gynecological or other pathologies, pain syndrome occurs 1-2 days before the onset of menstruation and continues for the first two days of bleeding. The intensity of the pain can vary from mild to severe and back.

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

  • general weakness and reduced performance,
  • anxiety, mood swings,
  • dizziness,
  • diarrhea or constipation
  • headaches, sometimes resembling a migraine,
  • dorsalgia (back pain),
  • swelling of the face and limbs
  • excessive sweating.

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

Diagnostics

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

  • General and gynecological examinations - outwardly a woman may look exhausted, pale, irritable and tired. With secondary dysmenorrhea, palpation on the chair reveals an increase in the uterus, infiltrates, and inflamed areas; with primary, there are no such changes.
  • Laboratory tests of blood and urine in the case of secondary algomenorrhea show increased white blood cells, changes in hormone levels, or other indicators characteristic of infectious-inflammatory or other pathologies.
  • Ultrasound can detect pathological changes in the internal genital organs, for example, the presence of a tumor, cysts, myomas, inflammation of the appendages.
  • MRI detects tumors, with primary dysmenorrhea, this method is not informative.
  • Diagnostic laparoscopy is rarely performed and is indicated if the treatment has failed.
  • Hysteroscopy is performed in case of suspected adhesions in the uterus.
  • Encephalography is prescribed if during the month there are severe headaches and allows you to identify diseases of the central nervous system.

Treatment of Algomenorrhea

With algomenorrhea treatment depends on the root cause of the problem. If it is endometriosis, inflammation of the ovaries, or other pathologies, then the attending physician selects the appropriate drugs and medical procedures - antibiotics, anti-spiking agents, vitamins, necessary physiotherapeutic methods.

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

They begin to take for 3-4 days before the onset of menstruation and end 2-3 days later. Examples of remedies are Ibuprofen, Diclofenac, Piroxicam, Naproxen.

For the relief of pain, effective means, which include a combination of antispasmodic and analgesic - Trigan, Spazmalgon, Baralgin.

In the medicamentous treatment of algomenorrhea also apply:

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

In the case of severe pain syndrome, anesthetics are administered intramuscularly or intravenously, complementing the treatment with antihistamines and sedatives.

Drug-free methods:

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

A tangible contribution to the struggle with painful periods is made by healthy eating, normalization of work and rest, elimination of stressful situations, moderate exercise, giving up bad habits, including coffee and smoking addiction.

Code algomenorrhea ICD10

In the international classification of diseases, each disease is assigned a number. Algomenorrhea in ICD10 has three codes:

  • 94.4 - primary,
  • 94.5 - secondary,
  • 94.6 - unspecified

Prolonged regular pain and feeling unwell before and during menstruation is a reason to be examined by a gynecologist.

What is algodysmenorrhea and how to treat it?

Algomenorrhea is a complex of symptoms during menstruation, which are accompanied by a strong pain syndrome and a violation of the patient’s general condition. The disease is widespread in women of childbearing age.

It occurs with anatomical defects of the uterus, hormonal changes, increased excitability of the central nervous system and inflammatory diseases of the genital organs. Algomenorrhea is characterized by cramping abdominal pain.

The diagnosis is made on the basis of clinical symptoms, gynecological examination and laboratory data. Outpatient treatment.

Algomenorrhea is a condition in which pains of a nagging character are noted at the beginning of the menstrual cycle, occurring against the background of general malaise. The disease is widespread in women of reproductive age.

  • Primary (essential). It begins in adolescence and is not combined with diseases of the reproductive system.
  • Secondary. It occurs after thirty years in inflammatory and non-inflammatory gynecological diseases.
  • BONE on the foot "dry" INSTANTLY!

Causes

Among the causes of primary algomenorrhea are:

  • mechanical,
  • endocrine,
  • psychogenic,
  • constitutional.

Mechanical pathological processes that interfere with the normal outflow of blood during menstruation. For example, a violation of the position of the uterus, atresia of the cervix.

The endocrine provoking factor is enhanced prostaglandin synthesis, but slow decay. They increase the contraction of the muscle layer in the uterus, causing a spasm. Thereby impair blood supply and increase the sensitivity of nerve fibers to pain. With prolonged vascular spasm, uterine contraction increases and pain sensitivity increases.

With psychogenic causes, the individual threshold of pain sensitivity decreases, patients do not accept their feminine essence and deny the sexual aspects of life. The constitutional cause of the disease is infantilism.

Tuesday algodismenorrhea develops:

  • against the background of inflammatory diseases of the female reproductive system,
  • after gynecological operations
  • in the presence of adhesions in the pelvis,
  • with complications of childbirth and cervical damage.

Common causes of the development of the disease include adenomyosis and endometriosis - proliferation of endometrial cells in the muscle layer of the uterus and beyond. Separated cells cause irritation of nerve fibers and increase the level of prostaglandins. Release of the last provokes pain and deterioration of the general condition.

  • IMPORTANT TO KNOW! Do not shear "fungal" nails! Nail fungus is derived as follows: treat your nails normal ...

With long-term inflammatory diseases, adhesions are formed, which can also provoke pain. Sometimes the disease develops due to the expansion of the pelvic veins after the installation of the intrauterine device.

Primary painful menstruation is often detected in emotionally unstable girls with a lack of body weight. Secondary is usually diagnosed in women older than thirty years, in the history of which there is an abortion, installation of the spiral, childbirth or surgery on the pelvic organs.

The main complaints of the patients are pain and malaise symptoms. Soreness occurs with the onset of menstruation or in front of her. The pain in the nature of the cramping, pulling or aching.

May radiate to the lower back, groin, perineal area, thighs. Their intensity may vary. A moderate degree is possible when the pain does not affect the ability to work and is relieved by painkillers.

In more severe cases, medical attention may be required.

The disease occurs with emotional and psychological problems. Before menstruation, a woman becomes irritable, touchy. Its mood decreases, drowsiness appears, appetite rises, decreases, taste is perverted.

Vegetative and vascular changes join. Hiccups begins, headaches, dry mouth, belching, nausea, vomiting, diarrhea, hot flashes, body temperature rises, urination increases.

There are two forms of the disease:

  1. Compensated - stable for many years.
  2. Decompensated - characterized by increased pain and deterioration of the general condition over time.

Since algodysmenorrhea indicates a violation of the reproductive system, not diagnosed in time or disregarding treatment can lead to infertility and disability.

Clinical manifestations

The symptoms of such a disorder, like primary algodimenorrhea, are not as pronounced as in secondary pathology. Therefore, the diagnosis of the disease in this case is difficult.

The main symptoms of secondary algomenorrhea depend on the cause of the development of the disorder in the patient. So, the most obvious symptoms in this disorder are:

  • pain in the lower abdomen, which comes a few hours before the onset of menstruation and can last for several days, and sometimes until the end of menstruation,
  • copious menstrual flow
  • violations of general well-being (headache, weakness, fatigue, sleep disturbance and lack of appetite).

Algodmenmenia rating scale

In some cases, the symptoms are complemented by increased body temperature, which can be increased slightly (subfebrile condition) or to febrile indices.

Also, the symptoms of algomenorrhea can be supplemented by symptoms of inflammatory or dystrophic processes in the pelvic organs:

  • heavy discharge from the vagina,
  • itching and burning in the genitals
  • pain during sexual intercourse,
  • swelling of the labia and other symptoms.

Therefore, before prescribing treatment, the doctor should carefully examine the patient to exclude the likelihood that she has other diseases that cause pain.

What is algomenorrhea in women

Algomenorrhea is a pain syndrome that occurs monthly during the first days of the menstrual cycle. The nature of pain varies depending on the personal characteristics of the woman’s body, as well as the causes of painful menstruation.

Algomenorrhea syndrome may be a symptom of a more serious disease, therefore, when a pathological condition appears, consult a gynecological clinic.

An individual clinical picture will allow the doctor to prescribe an adequate treatment to the woman or suggest a standard of care in case of pain during menstruation.

Classification

Algomenorrhea (code for ICB 10 - N94.4, N94.5, N94.6, in Latin - algomenorrhea) refers to one of the most frequent diseases in gynecology.

The disease is classified by the reasons of occurrence, which provoke a deterioration of health during menstruation.

The importance of classification is reflected in the treatment tactics that the gynecologist will undertake in order to combat the painful periods. Types of pathology:

Primary algomenorrhea. Almost all young gynecology patients know what it is in women. The onset of pain is observed in adolescents during the first one and a half years of menstruation. The syndrome develops as a result of psychogenic, endocrine, constitutional disorders.

At the same time signs of organic pathology of the pelvic organs are absent. Primary algomenorrhea is not associated with gynecological diseases, but often speaks of other dysfunctions of the body systems.

This type of disease has a strong connection with the individual perception of young girls of pain.

Secondary algomenorrhea. The form of the disease is directly related to the violation of the internal organs of the reproductive system.

In this case, pain during menstruation should be considered as a sign of other pathologies. The diagnosis of secondary genus algomenorrhea is made after examinations and determination of the underlying disease.

In addition to pain, this form of the disease contains symptomatic manifestations of the causative abnormality.

Symptoms and signs of the disease

The clinic of a pathological condition is quite characteristic for all variants of the disease. The main symptom of algomenorrhea is abdominal pain, which is able to give to the lower back, thighs, can be felt in the ovaries, uterus, or completely cover the abdominal region.

Type of pain pulling, cramping, pressing, aching, arching. The extent to which the pain syndrome is intense depends on the individual state of the body.

In some cases, the course of the disease is complicated: the body temperature rises, general weakness, sweating, headaches, dizziness, fainting appear, physical disability is lost. Some women suffer from nausea and vomiting, diarrhea, abdominal distension. Possible itchy genitals, a large amount of blood.

The painful sensations are of very high intensity, which requires the call of an ambulance with possible hospitalization. Doctors fill out a call card with personal data and the reason for feeling unwell.

Prevention

Prevention of dysmenorrhea - a healthy active lifestyle, in which the disease is much easier, the absence of bad habits.

Preventive recommendations include playing sports at least a few hours a week, eating healthy foods that affect the normal distribution of hormones in the body.

With the constitutional primary algodysmenorrhea, it is important to monitor the posture and correct the skeletal pathological changes in time, treat systemic diseases, monitor hormone levels and visit the gynecologist at least once a year.

Pathology description

Algomenorrhea - what is it? In simple terms, this condition is manifested by painful menstruation. In this case, the intensity of the discomfort may be different. Doctors say about such a concept as algodysmenorrhea, that this is a functional disorder of the 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 violation. To primary dysmenorrhea can be attributed to functional abnormalities of the woman 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.

Secondary algomenorrhea

This type of pathology also has two subspecies. Doctors secrete congenital and acquired algodismenorrhea. The first type includes various anomalies of the structure of the uterus and appendages that were formed during fetal development. Most often, the woman begins to disturb the symptoms 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, infections of the genital tract, and so on.

Symptoms of pathology

Depending on what causes algomenorrhea, its manifestations may be different. Absolutely always possible to distinguish pain. Discomfort can begin even a few days before the next bleeding.

After a certain time, they are amplified and cover the entire lower part of the abdominal cavity. Also, the pain may be in the tailbone or localized in the back.

In addition to the main symptoms, the diagnosis of algodysmenorrhea can manifest itself as follows:

  • psychological disorders and decreased libido,
  • deterioration of skin and hair,
  • the occurrence of prolonged or prolonged lung discharge 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 defecation. The last symptom may be diarrhea or constipation.

Is there a need for treatment?

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

Depending on the form and manifestation of symptoms, a treatment method should be chosen. Primary algomenorrhea is often not amenable to correction. Especially when it comes to its psychogenic form. Consider the main methods of treatment of this phenomenon.

Use of painkillers

In most cases, the pain before menstruation and during them women stop 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 low pain threshold, then it is simply impossible to treat.

It only remains to take such preparations as Nurofen, Mig, Paracetamol, Nise and so on regularly, as necessary.

Psychological correction and sedative medications

If a woman has a strong fear of pain before menstruation and during them, then, most likely, she will appear. This is a consequence of the normal reaction of the body.

It is worth noting that the treatment in this case is rather non-standard. Most often, the representative of the weaker sex is recommended to visit a psychotherapist.

The doctor will be able to somewhat correct the woman’s world view and free her from fear.

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 uterus and appendages, then antiviral, antimicrobial, and immunomodulating therapy is most often chosen. In this case, it is worthwhile to conduct a series of studies and find out the sensitivity of certain microorganisms to prescribed drugs.

In most cases, this correction gives positive results. A woman stops feeling pain in 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, an abnormal development of the uterine cavity and its appendages.

Also, the laparoscopic method can be used for diagnostic purposes and subsequent treatment.

Most often this happens when physicians are unable to establish the main cause of the illness, and conservative methods are powerless.

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

Treatment without medication

In most cases, this type of correction is chosen as an additional one. However, with implicit symptoms, it can also become major. It consists in maintaining a correct lifestyle and following 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 back.
  • During this period, you need to be in a good mood. Pamper yourself and try not to be nervous. Get enough sleep, walk more outdoors, watch your favorite movies.
  • Limit 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 on their own have disappeared after pregnancy and subsequent childbirth. In this case, doctors can not give a correct explanation for this fact.

Definition and General Information [edit]

Synonyms: algomenorrhea, intermittent pain, menstrual pain

Dysmenorrhea - uterine pain in terms close to menstruation. Pain may accompany menstruation or precede it in 1-3 days. The peak of pain is noted 24 hours after the onset of menstruation and subsides after 2–3 days. Usually the pain is acute, but can be spasmodic, throbbing, or dull and constant, may radiate to the lower limbs.

The frequency of dysmenorrhea in the pubertal period ranges from 43 to 90%. In 45% of patients dysmenorrhea occurs in severe, in 35% in moderate and in 20% in mild form.

There are primary (essential, idiopathic, functional) and secondary (acquired, organic) dysmenorrhea.

Etiology and pathogenesis [edit]

The development of dysmenorrhea is associated with congenital or acquired disorders of the synthesis and metabolism of eicosanoids (prostaglandins, thromboxanes and leukotrienes). Accumulating prostaglandins (PGs) and their degradation products cause discoordination of the contractile activity of the myometrium, accumulation of biologically active substances and calcium ions. The persistent dystonia of myometrium that develops in this case causes a violation of uterine blood flow, uterine ischemia, and the formation of painful sensations of varying severity. Hyperprostaglandinemia, in addition, underlies the pathogenesis of autonomic clinical manifestations of dysmenorrhea.

The role of undifferentiated connective tissue dysplasia in the pathogenesis of dysmenorrhea is discussed.

Unspecified dysmenorrhea: Treatment [edit]

Compliance with sleep and wakefulness, regulation of the diet with an increase in perimenstrual days of consumption of easily digestible and vitamin-rich foods and the exclusion of products based on milk and coffee, increasing the overall tone of therapeutic and recreational gymnastics. Perhaps the use of individual or collective psychotherapy. Effect on trigger points (acupuncture, acupuncture, magnetic therapy). Reflexology is more effective in combination with exercise therapy, diet, psychotherapy. Physiotherapy: diadynamic therapy, fluctuation, amplipulse therapy.

Displayed in the relevant sections:

Indications for surgery:

• persistent, not amenable to conservative treatment of dysmenorrhea (to clarify the cause of the disease),

• external genital endometriosis, including endometrioid ovarian cysts,

Short description

Dysmenorrhea (menstrual cramps) - pain in the suprapubic region, occurring shortly before and during menstruation. Primary dysmenorrhea (PD) - pathological signs during physical examination are absent. Secondary dysmenorrhea (VD) is a consequence of organic changes, pain is often more pronounced than with PD. Statistical data. The frequency of observation - 40% of adult women.

Etiology • PD - an increase of 2–7 times the production of Pg and other mediators causing uterine ischemia as a result of platelet aggregation, vasoconstriction, non-rhythmic contractions of myometrium fibers, exerting pressure exceeding the systemic • VD •• Congenital anomalies of the uterus and vagina •• Stenosis of the uterus •• Endometriosis •• Pelvic tumors (especially leiomyoma).

Risk factors • PD •• Absence of a history of childbirth •• Family history of dysmenorrhea • VD •• Small pelvic infections (including sexually transmitted diseases) •• Endometriosis.

Symptoms (signs)

Clinical picture

• Mild - discomfort, mild pain of constricting nature, heaviness in the suprapubic area on the 1st day of menstruation, other symptoms are absent.

• Medium degree - discomfort in the first 2-3 days of menstruation, unexpressed pain, accompanied by slight indisposition, diarrhea, headache.

• Severe - intense cramping pain for 2–7 days, pain in the lumbar region, thighs, headache.

• Differences of PD from VD •• PD - painful sensations begin simultaneously with menstruation and last for 1-3 days, pain is cramping or throbbing, localized in the lower abdomen, often radiating to the lower back and front surface of the thighs •• HP - pain often occurs 1-2 days before menstruation, the character depends from a specific cause (endometriosis, infection of the urogenital tract, etc.), in the history of the disease onset 12–24 months after the onset of menarche, a physical examination may detect a morphological substrate.

What is it in simple words?

Algomenorrhea is a regularly recurring painful menstruation accompanied by metabolic, hormonal, neurological and psycho-emotional disorders. Menstrual pains are in the lead (8–80%) among the complaints of young women to a specialist, but their presence is not always associated with gynecological pathology.

Causes of Algomenorrhea

The menstrual cycle is formed with the participation of all the most important systems of the body, so the cause of algomenorrhea can be both in the uterus and appendages, and far beyond the genitals.

Secondary algomenorrhea appears after a period of normal periods and is always associated with gynecological pathology. It is found among the symptoms of external or internal endometriosis, infectious-inflammatory processes of the pelvic region (endometritis, salpingo-oophoritis), submucous (submucosa) uterine fibroids, endometrial polyps, adhesions and other ailments. They are the cause of menstrual pain. There are cases of algomenorrhea on the background of the intrauterine device.

Algomenorrhea in adolescents has a primary character, appears with the first menstrual periods with a “healthy” uterus and appendages. Its causes are conventionally classified into groups:

  1. Hormonal: algodysmenorrhea often appears on the background of hormonal dysfunction in case of insufficiency of the second (luteal) phase. The appearance of pain is due to excessive influence of estrogen with insufficient concentration of progesterone.
  2. Endocrine: excessive contractions of the uterine muscles, resulting in its ischemia, are associated with impaired synthesis of prostaglandins - biologically active compounds that control the contractility of smooth muscles.
  3. Neuropsychogenic: painful menstruation often occur in girls with a labile psyche and low pain threshold.
  4. Constitutional: in sexual infantilism, the uterus is hypoplastic, and its muscles are underdeveloped and poorly stretched due to the accumulation of menstrual blood.
  5. Mechanical: menstrual pain may be associated with malformations of the genitals: partial or complete congestion (atresia) of the cervical canal, the incorrect position of the uterus, or its underdevelopment. The presence of abnormalities in the development of the genitals lead to the difficulty of free flow of menstrual blood, it accumulates in the uterine cavity, stretches it and provokes pain.

It should be noted that the concept of pain during menstruation in different patients is not the same. It is determined by the individual pain threshold. If the examination of the patient with algodimenorrhea did not reveal organic pathology, no associated systemic symptoms and progression of pain intensity, we can talk about the physiological features of pain perception.

Symptoms and first signs

The symptoms of such a disorder, like primary algodimenorrhea, are not as pronounced as in secondary pathology. Therefore, the diagnosis of the disease in this case is difficult.

The main symptoms of secondary algomenorrhea depend on the cause of the development of the disorder in the patient. So, the most obvious symptoms in this disorder are:

  • pain in the lower abdomen, which comes a few hours before the onset of menstruation and can last for several days, and sometimes until the end of menstruation,
  • copious menstrual flow
  • violations of general well-being (headache, weakness, fatigue, sleep disturbance and lack of appetite).

In some cases, the symptoms are complemented by increased body temperature, which can be increased slightly (subfebrile condition) or to febrile indices. Also, the symptoms of algomenorrhea can be supplemented by symptoms of inflammatory or dystrophic processes in the pelvic organs:

  • heavy discharge from the vagina,
  • itching and burning in the genitals
  • pain during sexual intercourse,
  • swelling of the labia and other symptoms.

Therefore, before prescribing treatment, the doctor should carefully examine the patient to exclude the likelihood that she has other diseases that cause pain.

Treatment prognosis

If the patient is diagnosed with a disease that belongs to the primary form of the pathology, the prognosis of algomenorrhea is quite favorable. You only need to adjust your lifestyle, diet 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 underwent an examination and adequate treatment, then we can expect a full recovery or at least a reduction in the intensity of painful manifestations. The end result in this case significantly depends on the severity of the disease, which causes such symptoms.

The main omen of a woman is the birth of a child. And if the symptoms described above start to bother her, you shouldn’t be forced to go to the doctor. Pain can speak about the development in the patient's body of a rather serious disease. Conclusion one. 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 turn to a specialist in time and in any case not to give up, your health, first of all, is in your hands.

How pathology manifests itself

According to medical statistics, 10% of girls and women have a diagnosis of algodimenorrhea. This is primarily a strong paroxysmal pain in the lower abdomen, accompanied by other signs. It is caused by natural for critical days contractions of the smooth muscles of the uterus.

Physicians name the determining cause of indisposition as prostaglandins. These substances are synthesized by the body, they are designed to stimulate the activity of the uterus, so that the outgoing mucosa can be rejected and brought out. But their excess amount provokes vascular spasms of the endometrium and the pelvic in general.

Stagnation of blood in the veins leads to a lack of oxygen in the tissues, irritation of the nerve roots and pain. Strengthen its calcium salts, accumulated in the cells. They cause an increase in intrauterine pressure, which increases the intensity and frequency of organ contractions.

If a woman with horror waits for critical days, pre-setting herself for pain, she will have a pathology rather than a more balanced person.

Accompanying algomenorrhea in women with different psycho-emotional features

When making a diagnosis of algodysmenorrhea, the ICB draws attention to the symptoms associated with the indisposition. The response of the body to pain may vary depending on the vegetative status of the patient:

  • With the active functioning of the sympathetic CNS, migraine-like phenomena, nausea, fever, chills are observed. The woman is also worried about vascular manifestations: heart pain, tachycardia, weakness and dizziness. Do not lag behind and malfunction of the digestive system: colic in the intestines, constipation. The skin becomes pale. This is accompanied by anxiety, insomnia, can develop to a depressive state,
  • The predominance of the parasympathetic type of pain perception leads to increased salivation with subsequent vomiting, slowing of the heart rhythm, fainting, feeling of lack of air. In women with similar vegetative features, the swelling of the tissues with PMS and weight gain are strongly pronounced, diarrhea and flatulence are observed. They are apathetic on critical days, drowsy,
  • The mixed type is characterized by weakness, shortness of breath, low temperature, pressure surges, pain in the head and heart. Emotional background on critical days in women is unstable: bouts of irritability turn into apathy, they can be replaced by anxiety, sleep is disturbed.

Types of disease

The disease associated with vegetative status algomenorrhea μB 10 divides into primary and secondary. A narrower diagnosis means in this case the causes of its occurrence. The last in the classification is algodismenorrhea, unspecified, in which there are no obvious reasons for the appearance of sensations, it goes under the number 94.6.

Primary algomenorrhea, code on the ICD 10 No. 94.4, is found in adolescents and young women. It makes itself felt in a year and a half after the first-time menstruation, that is, together with the stabilization of ovulation and the acquisition of a regularity cycle. Pain manifested with the onset of menstruation, capture not only the lower abdomen, but also give to the area of ​​the sacrum, the inner space of the thighs. Other signs already mentioned are also acute.

This happens more often in thin, thin-boned girls suffering from vegetative-vascular dystonia, emotional, fearful. Some of them during examination revealed hypoplasia of the uterus, but in general, algomenorrhea μB 10 No. 94.4 occurs in cases when the genitals do not differ in any abnormalities.

The secondary form of the pathology is acquired. For many years, a woman may not know the problems with menstruation. But diseases of the reproductive organs can lead to such features of their development, that the removal of menstrual flow is difficult, and there is intolerable pain. Algodysmenorrhea secondary code according to MKB 10 is numbered 94.5 and appears as a result:

  • Endometriosis. When cells similar to the components of the uterine mucosa, spread outside the body, as well as into its layers, their cyclic development does not differ from normal ones. That is, during menstruation, they are removed, forcing to strengthen the contractions of the organ, affecting the adjacent areas of the pelvis and abdominal cavity. Therefore, a larger number of nerve endings are involved in the process,
  • Myomas. Located on the path of the withdrawal of menstrual flow, it provokes stagnation of blood. This causes the myometrium to contract more actively, increasing the sensations
  • Chronic inflammatory diseases of the uterus, after which the formation inside the organ of adhesions or a change in its position is possible. In both cases, the selection can not be easily displayed,
  • The use of intrauterine contraceptive. Spirals provoke increased production of prostaglandins. And these substances increase the amplitude and frequency of movements of the smooth muscles of the uterus,
  • Damage sustained during childbirth, abortion. Because of them, the appearance of mechanical obstructions for rejected menstrual mucus is also likely
  • Varicose veins in the pelvis. The protrusion of their walls, swelling of the tissues increase the vibrations of the nerve roots, and therefore pain.

We recommend reading the article about back pain during menstruation. You will learn about the causes of discomfort in the back, possible diseases, ways to eliminate painful sensations.

How else is algodismenorrhea classified?

The MKB code of algodysmenorrhea forces one to pay attention also to such parameters as the strength of painful sensations, the severity and features of the course of indisposition. According to these criteria, it is divided into

  • Easy The pain on critical days is mild, practically not interfering with everyday life, not requiring the use of medications,
  • Moderate. Feelings interfere with performance, but are removed using analgesics,
  • Heavy. The pain is intense, complemented by the whole complex of symptoms, the performance is almost at zero. With this degree of pathology, analgesics almost do not help, the effect of their use is weak and short-term.

With the diagnosis of algomenorrhea, the ICD divides the condition into

  • Compensated, in which the intensity of pain remains at the same level during many cycles,
  • Decompensated, when the sensations increase with each passing year or even more often.

In all cases, there are ways to get rid of it, or at least stabilize it for the time of critical days.

Pin
Send
Share
Send
Send