Many people believe that dysmenorrhea is incurable, mainly because they do not have a correct understanding of it. In addition to gynecological diseases, most dysmenorrhea is caused by genetics or uterine dysplasia. Before each menstrual period or before the end of the period, the uterus will stretch, and the related central nerve will transmit the discomfort information encountered during the stretching of the uterus to the brain, which will be expressed as a paroxysmal pain. Dysmenorrhea is actually a disease rather than a symptom. Except for gynecological diseases that cause dysmenorrhea that should be treated in gynecology, chronic dysmenorrhea should be treated in pain medicine, and it is completely curable. In addition, women with dysmenorrhea should not take analgesics at will, because most steroidal analgesics, such as fen-phen, have side effects that damage the gastrointestinal mucosa, liver and kidneys, and long-term use can lead to gastrointestinal bleeding, etc. Generally speaking, women with chronic dysmenorrhea who take three painkillers each time still have no effect should go to the hospital as soon as possible, and hospitals with pain departments can go directly to the If a hospital has a pain department, you can go directly to the pain department. The endometriosis is one of the hidden dangers behind menstrual pain: endometriosis. I’m afraid we are not unfamiliar with endometriosis, as many genital lesions can cause secondary dysmenorrhea, including endometriosis. The location of the pain varies from person to person and the symptoms may vary depending on the location of the lesion. About 20% of patients have no significant discomfort. Secondary dysmenorrhea is a typical symptom of endometriosis and tends to increase year by year with the aggravation of the local lesion. The main manifestations are dysmenorrhea and persistent lower abdominal pain. The pain is mostly located in the lower abdomen and lumbosacral region, and may spread to the vagina, perineum, anus or thighs. It often starts one to two days before menstruation, is most intense on the first day of menstruation, and continues until it gradually subsides after menstruation, so those with longer periods tend to have longer duration of pain, which is most prominent in patients with endometriosis. Treatment should be considered in a comprehensive manner depending on the patient’s age, symptoms, location and extent of the lesion, as well as the requirements for fertility. In principle, patients with mild symptoms should be treated with expectant therapy; mild patients with fertility requirements should be treated with medication first, and those with more severe lesions should undergo conservative surgery; severe patients who are young and do not require further fertility may undergo surgery to preserve ovarian function supplemented with hormone therapy; patients without fertility requirements who have severe symptoms and lesions may consider radical surgery. The second hidden danger behind dysmenorrhea: uterine fibroids Uterine fibroids are the most common benign tumors of the female genitalia. Fibroids are uterine tumors that protrude into the uterine cavity. Because they are covered with endometrium and occupy the uterine cavity, they can affect the discharge of menstrual blood, thus causing abnormal contraction of the uterus and painful menstruation, accompanied by heavy menstruation and cycle disorders. Symptoms of pressure on its adjacent organs can occur, and severe abdominal pain can occur when the myoma degenerates or when the subplasmalemma is twisted by the tip. Treatment must be considered comprehensively according to the patient’s age, fertility requirements, symptoms, and the size of the fibroids. Treatment is carried out according to the actual situation. Diagnosis of dysmenorrhea: 1. The diagnosis of primary dysmenorrhea lies mainly in excluding the possibility of secondary dysmenorrhea. A detailed history should be taken, paying attention to the time of pain onset, type and characteristics. The diagnosis of primary dysmenorrhea can be made based on: (1) the onset of pain within 1 to 2 years after menarche; (2) the onset of pain a few hours before the appearance of menstrual blood or pain lasting no more than 48 to 72 hours; (3) the nature of the pain being spasmodic or similar to labor and delivery pain; (4) negative gynecological duplex examination or anal examination. The diagnosis of primary dysmenorrhea can be made. 2.Diagnosis of secondary dysmenorrhea Secondary dysmenorrhea may appear several years after menarche. Most of them have a history of excessive menstruation, irregular menstrual cycle, infertility, IUD placement, infertility, pelvic inflammatory disease, etc., which can help the diagnosis of secondary dysmenorrhea. In gynecology, double and triple diagnosis can reveal some causes of dysmenorrhea, such as uterine malformations, uterine fibroids, ovarian tumors, pelvic inflammatory masses, etc. Anal examination reveals nodular thickening of the uterosacral ligament, which is especially important for early diagnosis of endometriosis. Other tests: such as blood sedimentation, leuko-bacterial culture, ultrasound pelvic scan, hysterosalpingography, diagnostic scraping, and finally the application of hysteroscopy and laparoscopy can clarify the cause of dysmenorrhea at an early stage. Hysteroscopy can detect small lesions missed during curettage, such as small fibroids, polyps, ulcers, etc., and these valuable diagnostic bases can be performed after diagnostic curettage. Here I will introduce the treatment of dysmenorrhea. 1, general treatment: pay attention to psycho-spiritual treatment, clarify that mild discomfort during menstruation is a physiological reaction. When the pain is intolerable, non-narcotic analgesic treatment can be used, with appropriate application of analgesia, sedation and antispasmodic. Many patients have less menstrual pain after taking the right amount of vitamins and minerals every day. He recommends taking a combination of vitamins and minerals, preferably those containing calcium and in low doses, which you can take several times a day (after meals). ② Mineral supplementation Calcium, potassium and magnesium minerals, can also help relieve menstrual pain. Experts have found that women who take calcium also have less menstrual pain than those who do not. Magnesium is also important because it helps the body absorb calcium efficiently. It is a good idea to increase your calcium and magnesium intake just before and during your period. The caffeine in coffee, tea, cola and chocolate can make you nervous and may contribute to discomfort during menstruation. Therefore, caffeine should be avoided. In addition, the oils and fats in coffee may also irritate the small intestine. If you are prone to edema during menstruation, alcohol will aggravate the problem. Do not drink alcohol. If you have to, limit it to 1 or 2 drinks. Eat a balanced diet Most women skip regular meals and eat too many sweets and salty foods. While a healthy diet will not eliminate menstrual pain, it can work wonders for improving general health. Avoid overly sweet or salty junk food, which can make you bloated and sluggish, and eat more vegetables, fruits, chicken and fish, and try to eat small, frequent meals. (6) Do not use diuretics Many women believe that diuretics can reduce the discomfort of swelling during menstruation, but Dr. Lark opposes this approach. Diuretics will excrete important minerals, along with water, from the body. Dr. Lark recommends reducing the intake of salt and alcohol, which can cause water to be trapped in the body. Keeping your body warm will increase blood circulation and relax your muscles, especially in the spastic and congested pelvic area. Drink plenty of hot herbal tea or hot lemon juice. You can also place a hot pad or hot water bottle on your abdomen for a few minutes at a time. ⑧ Soak in a mineral bath Add 1 cup of sea salt and 1 cup of sodium bicarbonate to a tub of warm water. Soak for 20 minutes to help loosen muscles and ease menstrual pain. ⑨ Practice yoga exercises Yoga also has a soothing effect. An example is as follows. Bend your knees and sit on your heels. Press your forehead to the ground and stretch your arms out straight against your sides. Hold this position until you feel uncomfortable. ⑩ Take painkillers Aspirin and acetaminophen can relieve menstrual pain. However, more effective adult medicines include Advil, Haltran, Medipren and Nuprin, which contain ibuprofen, which inhibits the action of prostaglandins. When menstrual pain starts, take it with some milk or food (1 tablet) to avoid hurting your stomach, and continue taking it until the pain disappears. 2. Prostaglandin synthase inhibitors: There are two types, both of which can inhibit the cyclooxygenase system and reduce the production of PG (prostaglandins). The first category is phenylpropionic acid: such as ibuprofen 400mg, 4 times a day. Dysmenorrhea relief rate is 90%. The second type is the phenylpropionic acid class, such as chlorophenolic acid 200mg, 3 times a day, or mefenamic acid 500mg, 3 times a day, which can be taken when menstruation starts, for 2~3 days, with rapid and complete effect, because the phenylpropionic acid class also has PG antagonist property, which can be directly blocked at the receptor site. 3, oral contraceptives inhibit ovulation: for women with dysmenorrhea who require contraception, the efficacy is more than 90%. The pill inhibits the growth of endometrium and reduces menstrual flow; the drug inhibits ovulation, luteinizing, and no endogenous progesterone production, while progesterone stimulation is necessary for endometrial biosynthesis of PG, thus reducing the concentration of PG in menstrual blood, and estrogen and progesterone sequential therapy is feasible for unmarried girls to reduce symptoms. If these methods are ineffective, nerve block therapy, such as paravertebral drug injection or sacral drug injection, can be implemented, which has good effect.