I believe that every woman compatriot in her life before and after the arrival of the “period” more or less will have so “a little” uncomfortable, or lower abdominal pain, swelling, or headache, dizziness, fatigue, and then there is diarrhea, vomiting, back pain and other discomforts, these are the manifestations of dysmenorrhea. These are all symptoms of dysmenorrhea. Now we will take a good look at dysmenorrhea with you! The main factors affecting the development of dysmenorrhea are age, childbirth, genetics and environmental factors. Age is an independent correlate of dysmenorrhea in primary dysmenorrhea, and increasing age has a protective effect on dysmenorrhea. Childbirth can also significantly reduce the degree of dysmenorrhea, mainly because late pregnancy can “destroy” the adrenergic nerves that innervate the uterus, and these nerves are difficult to restore after delivery, so they will not be so “arrogant”! Primary dysmenorrhea (a) etiology The causes of primary dysmenorrhea are mainly related to the abnormal contraction of the uterus, the synthesis and release of prostaglandins, the role of vasopressin, the level of NO, and mental and psychological factors. 1. Abnormal uterine contraction Enhanced uterine muscle activity can lead to increased uterine tone and spasmodic contraction, which further leads to the occurrence of dysmenorrhea. In the late luteolysis of the corpus luteum, lysosomal instability releases phospholipase A2, activating cyclooxygenase, increasing prostaglandin synthesis, leading to changes in uterine muscle tone and uncoordinated contractions, prostaglandins cause dysmenorrhea there are other mechanisms, and to listen to the author for you to talk about. 2, prostaglandins Prostaglandins are widely found in human tissue, is a key molecule in the regulation of reproductive processes, with the role of stimulating uterine smooth muscle. The endometrium is the main part of the synthesis of prostaglandins, prostaglandin F2α and thromboxane A2 can stimulate excessive uterine contractions, resulting in reduced uterine blood flow, which further leads to uterine ischemia, Chinese medicine said that “not through the pain” is profoundly embodied here. 3, the role of vasopressin Elevated levels of vasopressin can cause the myometrium and arterial wall smooth muscle contraction enhancement, uterine blood flow is reduced, resulting in uterine ischemia, pain. Vasopressin V1a receptor antagonists can reduce the increased pressure in the uterine cavity caused by vasopressin and relieve dysmenorrhea. Contractions will also do the same thing (this time you should know why it hurts for women to give birth!) The same is true of oxytocin, which is also used to relieve menstrual cramps. 4, nitric oxide (NO) NO in the nociceptive modulation process involved in the central and peripheral level of nociceptive regulation, the performance of the “dual role”. When its content decreases, it can promote the transmission of injurious information and cause pain, and when it increases, its inhibitory effect and analgesia. Mental stress can directly or indirectly affect the synthesis of prostaglandins in the endometrium and lead to dysmenorrhea. （Diagnosis is mainly differentiated from secondary dysmenorrhea and chronic pelvic pain caused by organic pelvic lesions. Commonly used examination methods include ultrasound, laparoscopy, hysteroscopy, and uterine tubal iodine oil angiography. （General treatment Bed rest and hot compresses on the lower abdomen can relieve the symptoms, and it is also important to pay attention to menstrual hygiene. Salicylate analgesics can also reduce fever and relieve pain. Prostaglandin synthetase inhibitors [first-line drugs] are commonly used non-steroidal anti-inflammatory drugs (indomethacin, ibuprofen, ketoprofen). By reducing the synthesis of prostaglandins, they can relieve the spasmodic uterine contractions caused by prostaglandins. Start taking them for 2-3 days after the onset of menstruation and the onset of pain. Commonly used drug dosage and administration: Ibuprofen (200-400mg/q6h); Flumicidin (100-200mg/q6-8h); Meprobamate (500mg in the first dose, 250mg/q6h, stronger action than flumicidin, can aggravate asthma, asthmatics use with caution!) Diclofenac (25-50mg/q6-8h); Naproxen (first dose 500mg, 250mg/q8h); Diclofenac (25mg/q8h). Pros: effective, easy to take, few side effects. Disadvantages: not to be taken for a long time. Contraindications: pregnant and lactating women; peptic ulcer; nasal polyp syndrome; allergic to aspirin or similar drugs. 3, oral contraceptives [second-line drugs] for people: the first line of drugs (prostaglandin synthase inhibitors) have contraindications; the first line of drugs with poor therapeutic effects. Mechanism of action: reduce the amount of menstruation, inhibit ovulation, reduce the level of estrogen in the blood, inhibit uterine activity. Advantages: can be taken for a long time. 4.Calcium channel blocker (nicardipine) Mechanism of action: inhibit calcium ions from “running” out of the cell, inhibit calcium ions through the uterine smooth muscle cells outside the membrane into the cell, inhibit uterine smooth muscle contraction, relieve spasm, dilate blood vessels, improve blood supply. 5.Chinese medicines: Tongjie Shao Yao San, Nei Yi Pain Relieving Tang, An Shen Ding Pain Soup, Jia Wei Antispasmodic San …… 6.Crucifixion massage method: the patient lies on the side, the lower leg is straightened, the upper leg is flexed, and repeated rapid massage is performed at the thoracic 10 and the lumbar 5-sacral 1, as well as at the sacroiliac joints. 7.Transcutaneous Nerve Stimulation (TENS) One transcutaneous nerve stimulator and three electrodes (two yin and one yang) are needed. It is effective and no side effects or complications have been found. 8.Surgery Anterior sacral neurectomy and uterosacral neurectomy. Therapeutic effect and long-term complications need to be further explored. Second, secondary dysmenorrhea Etiology: endometriosis, adenomyosis, pelvic infection, endometrial polyps, submucosal fibroids, uterine adhesions, uterine malformation, pelvic congestion syndrome, intrauterine device, hymenal atresia …… and other pelvic organic pathologies. Treatment: treatment of the original disease. It seems that dysmenorrhea can really cause a lot of social and economic problems …… To summarize, for the treatment of dysmenorrhea must distinguish between primary (the cause can not be found out) or secondary (the cause is more clear, there is a primary disease), and then decide whether to use symptomatic or causative treatment or integrated treatment.