引起痛经的原因很多,一般都与心理精神因素有关,如情绪激动(生气)、抑郁、精神紧张等,有时过度疲劳、剧烈活动、淋雨、受凉、大量服冷饮等也可以引起痛经。
原发性痛经一般均认为应归咎于以下几种原因:内膜管型脱落(膜性痛经)、子宫发育不全、子宫屈曲、颈管狭窄、不良体姿及体质因素、变态反应状态及精神因素等。
继发性痛经, 痛经病人经双合诊发现盆腔器官有病变者为继发性痛经。常由于局部异常体征尚不明显时误诊为原发性痛经,因而对痛经开始于初潮后3年以上者,应考虑继发性痛经之可能,应进一步检查。
青年女性继发性痛经之常见原因为子宫内膜异位症,它与原发性痛经症状极相似。如果病人有进行性痛经或内膜异位症家族史(母或姐妹中有患此病者),应早作腹腔镜检查以明确诊断,及早进行保守性手术治疗,以保存生育能力。网址:Www.hyfYmz.com
此外,继发性痛经病因有:先天性子宫畸形(包括双角子宫、中隔子宫、残角子宫、阴道横隔等)、盆腔炎症、子宫腺肌病、子宫肌瘤、子宫息肉、子宫粘连、宫颈管狭窄、卵巢囊肿及盆腔瘀血综合征等。
除痛经外,月经期伴有体温升高者应考虑盆腔炎。带宫腔节育器痛经者占带器妇女的5%左右。如无感染情况,痛经发生原因可能是节育器刺激内膜,PGs释出过多导致子宫肌肉收缩过强所致。
子宫畸形、生殖道下段完全阻塞之病人,可出现周期性下腹部疼痛,初潮年龄已过仍无月经来潮,而其它第二性征发育情况正常。周期性下腹疼痛乃继发于生殖道积血,一般在乳房发育开始后2~3年内出现。生殖道畸形阻塞、处女膜闭锁及阴道横隔,通过妇科检查很易得到诊断。而如融合缺陷形成一侧生殖道阻塞、对侧通畅者则较难诊断,如未分离之双子宫、一侧阴道盲端或有一与阴道不相通的残角子宫,这类病人有渐渐加重的痛经史,扪诊可触得肿块,易误诊为阴道囊肿或卵巢肿瘤。
腺肌病、内膜息肉及子宫肌瘤均较罕见于青春期少女。由这类病变诱发之痛经常在25岁后出现,疼痛类型不定,疼痛持续时间较长。
Dysmenorrhea - women's distress
Dysmenorrhea caused by many reasons, generally with the spirit of psychological factors such as emotional (angry), depression, stress and so on, and sometimes fatigue, severe, get wet in the rain, cold, cold drinks and so on a large number of services can also be caused by dysmenorrhea.
Primary dysmenorrhea generally should be attributed to the following reasons: endometrial cast off (membrane of Dysmenorrhea), uterine hypoplasia, buckling the uterus, cervical stenosis, poor body posture and physical factors, allergy and mental state factors And so on.
Secondary dysmenorrhea, dysmenorrhea patients by bimanual pelvic organs was found to have lesions are secondary dysmenorrhea. Often due to local abnormal signs is not yet clear when misdiagnosed as primary dysmenorrhea, which began on dysmenorrhea in 3 years after menarche, consideration should be given to secondary dysmenorrhea of possible further examination.
Young women of secondary dysmenorrhea for the common cause of endometriosis, with symptoms very similar to those of primary dysmenorrhea. If the patients have progressive dysmenorrhea, or a family history of endometriosis (mother or sister who have this disease), should be made as soon as possible in order to clear diagnostic laparoscopy, conservative surgery for early treatment to preserve fertility.
In addition, the cause of secondary dysmenorrhea: congenital uterine malformation (including double uterus, uterine septum, the rudimentary horn of the uterus, vagina every other cross-etc.), pelvic inflammatory disease, adenomyosis, uterine fibroids, uterine polyps, uterine adhesions , Cervical stenosis, ovarian cysts and pelvic congestion syndrome, and so on.
In addition to dysmenorrhea, menstrual periods were associated with elevated body temperature should be given to pelvic inflammatory disease. IUD with dysmenorrhea who intrauterine device with women accounting for about 5%. In the absence of infection, dysmenorrhea may be due to the occurrence of endometrial stimulation IUD, PGs led to the release of excessive uterine muscle contraction caused by too.
Uterine abnormalities, reproductive tract under paragraph complete obstruction of the patient, can be cyclical lower abdominal pain, no period is over the age of menarche Lai Chao, and other secondary sexual characteristics and normal development of the situation. Cyclical abdominal pain is secondary to the reproductive tract hemorrhage, breast development in general after the emergence of two or three years. Reproductive tract abnormalities obstruction hymen and vaginal atresia Wang separated by gynecological examination is very easy to be diagnosed. The side of the formation of defects such as the integration of reproductive tract obstruction, the opposite is more difficult to clear diagnosis, if the separation of double uterus, vagina side of the blind side the vagina or not connected with a rudimentary horn of the uterus, these patients have gradually increased The history of dysmenorrhea, can touch a patient palpable mass, the vagina misdiagnosed as ovarian cyst or tumor.
Adenomyosis, endometrial polyps and uterine fibroids were rarely seen in adolescent girls. By this type of lesion-induced pain often occur after the 25-year-old, the type of pain and uncertainty, the longer the duration of pain.
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