Heinrichs W L, Adamson G D
J Reprod Med. 1980 Oct;25(4 Suppl):236-42.
Pelvic pain associated with the menses may be a result of physiologic problems, premenstrual tension syndrome, primary dysmenorrhea or secondary dysmenorrhea. All of these conditions may be caused by both physiologic and psychologic factors. An accurate diagnosis requies a complete history and physical examination and astute assessment of predisposing or aggravating conditions. Diagnosis has been improved through the use of laparoscopy, hysteroscopy, hysterosalpingography and dilatation and curettage. Treatment has been revolutionized with the use of oral contraceptives and prostaglandin synthesis inhibitors. These diagnostic and therapeutic advances now enable the sympathetic physician to effectively evaluate and treat almost all patients with menstrually related pelvic pain. When all of these approaches fail, the physician should consider psychiatric consultation or referral to pain clinic or gynecologist with special interest in this field.
与月经相关的盆腔疼痛可能是生理问题、经前紧张综合征、原发性痛经或继发性痛经的结果。所有这些情况都可能由生理和心理因素引起。准确的诊断需要完整的病史、体格检查以及对易感或加重病情的敏锐评估。通过腹腔镜检查、宫腔镜检查、子宫输卵管造影术以及刮宫术，诊断得到了改善。口服避孕药和前列腺素合成抑制剂的使用使治疗发生了变革。这些诊断和治疗上的进展现在使富有同情心的医生能够有效地评估和治疗几乎所有与月经相关的盆腔疼痛患者。当所有这些方法都失败时，医生应考虑进行精神科会诊，或将患者转诊至疼痛诊所或对该领域有特殊兴趣的妇科医生处。
