Dysmenorrhea (painful menstruation) is defined as a condition of severe uterine pain during menstruation. Some women may experience periodic pains during or prior to, or after menstrual periods in the lower abdomen as resulting of over production of certain hormones in the prostaglandins family. In traditional Chinese medicine, dysmenorrhea is defined as a pain in the lower abdomen, appearing with menstrual cycle that can spread over to the whole abdomen and lumbosacral region, depending to diagnosis.
Types of dysmenorrhea
1. Primary dysmenorrhea
Primary dysmenorrhea is defined as no underlying cause for menstrual cramps or difficult menstruation occurring just before or during menstruation. It occurs about 90% in the girls in the first 2 years of menstruation. Some researchers suggested that it may be caused immature of the reproductive organs.
2. Secondary dysmenorrhea
Secondary dysmenorrhea is caused by gynecological diseases. including hormone imbalance, endometriosis, fibromas, pelvic immflammatory disease, etc.
1. Spasmodic abdomen cramps
8. Abdominal bloating
9. Painful breasts
After taking a brief family history and the physical exam including the Abdominal, pelvic, and rectal examinations to check any abnormality of which may be the underlined causes. Diagnosis in general includes
A. In primary dysmenorrhea
If the secondary dysmenorrhea underlined causes (See below) are rule out. No further test will be required.
B. In secondary dysmenorrhea
A. Blood test
1. Erythrocyte sedimentation rate (ESR)
The test is to rule out any inflammation is present in the body. The higher the level of ESR may be an indication of inflammation.
The aim of the test is to determine the levels of Electrolytes, including Sodium, Chloride, Potassium, calcium, etc. to rule out the imbalanced electrolytes cause of dysmenorrhea.
3. Pregnancy test
The test is to rule out the ectopic pregnancy cause of the condition.
4. Tumor markers
The blood test of tumor markers is to rule out the malignant or benign tumor cause of dysmenorrhea.
B. Swab of vaginal discharge
The aim of the test is to rule out any sexual transmitting diseases cause of the problem.
C. Other tests
Laparoscopy is a long, thin like tube with light and camera at the end insert into a woman abdomen to allow her doctor to visualize and abnormality in the abdomen region in the computer screen to rule out the cause of dysmenorrhea, such as ectopic pregnancy, endometriosis and pelvic inflammatory disease.
2. Dilatation and curettage
Dilatation and curettage (D & C) is procedure in which the cervix is dilated (expanded) and the lining of the uterus (endometrium) is scraped away to allow a visualization of the uterine cavity.
3. Pelvic ultrasound
Pelvic ultrasound allows your doctor to visualize the ovaries and around structures to check for any abnormality in the pelvic region, including uterus or fallopian tube, ovaries and ectopic pregnancy.
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