Gutman Gail, Nunez Ariel Tassy, Fisher Martin
Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
Curr Probl Pediatr Adolesc Health Care. 2022 May;52(5):101186. doi: 10.1016/j.cppeds.2022.101186. Epub 2022 May 4.
Studies show that between 41% and 91.5% of young women, school-aged and university-aged, are affected by dysmenorrhea. Primary dysmenorrhea, which is caused by the production of prostaglandins, is defined as cramping pain in the lower abdomen and/or pelvis occurring just before or during menstruation, in the absence of other diseases such as endometriosis, and typically lasting 1-3 days and with a negative physical examination. Secondary dysmenorrhea presents with similar signs and symptoms but is a result of underlying pelvic pathology, for example endometriosis or uterine fibroids. Dysmenorrhea most typically presents as abdominal cramping; however, it can also present with headaches, nausea, vomiting or other generalized symptoms. The diagnosis is mainly clinical, but other tests such as a pelvic examination, a pregnancy test and STI screening may be helpful in ruling out other sources of pain. Although the mainstay of treatment for dysmenorrhea is NSAIDs and hormonal therapy, lifestyle changes and complementary/alternative medicine can also be helpful approaches. Lifestyle changes include aerobic exercise and stretching, while complementary alternative medicine include peppermint, cinnamon, ginger and other herbs and supplements. Finally, endometriosis must be considered as a potential cause for secondary dysmenorrhea and would warrant a prompt referral to gynecology.
研究表明，41%至91.5%的学龄期和大学适龄期年轻女性受痛经影响。原发性痛经由前列腺素产生引起，定义为在月经前或月经期间下腹部和/或骨盆出现痉挛性疼痛，且不存在子宫内膜异位症等其他疾病，通常持续1至3天且体格检查结果为阴性。继发性痛经表现出类似的体征和症状，但它是由潜在的盆腔病变导致的，例如子宫内膜异位症或子宫肌瘤。痛经最典型的表现为腹部痉挛；然而，它也可能伴有头痛、恶心、呕吐或其他全身性症状。诊断主要依靠临床，但其他检查，如盆腔检查、妊娠试验和性传播感染筛查，可能有助于排除其他疼痛来源。虽然痛经的主要治疗方法是使用非甾体抗炎药和激素疗法，但生活方式的改变以及补充和替代医学也可能是有效的治疗方法。生活方式的改变包括有氧运动和伸展运动，而补充替代医学包括薄荷、肉桂、生姜和其他草药及补充剂。最后，子宫内膜异位症必须被视为继发性痛经的一个潜在原因，这需要及时转诊至妇科。
