Venturini P L, Fasce V, Gorlero F, Ginocchio G
Department of Gynaecology and Obstetrics, University of Genoa, Genova, Italy.
Cephalalgia. 1997 Dec;17 Suppl 20:29-31. doi: 10.1177/0333102497017S2009.
A correct classification of female pelvic pain originating from gynaecological disorders is essential if the most appropriate therapy is to be chosen. Certain types of non-steroidal anti-inflammatory drugs and oral contraceptives reduce the production of prostaglandins, which are responsible in large part for primary dysmenorrhoea. Oestroprogestin formulations become the drugs of choice if the patient also requests contraception. Secondary dysmenorrhoea and chronic pelvic pain may require combined medical and surgical treatment. Oral contraceptives can also be used as post-treatment agents in endometriosis, one of the most common causes of pelvic pain, whereas more specific compounds (GnRH-analogues and Danazol) are used to produce anatomical regression of endometriosis.
如果要选择最合适的治疗方法,对源自妇科疾病的女性盆腔疼痛进行正确分类至关重要。某些类型的非甾体抗炎药和口服避孕药会减少前列腺素的产生,而前列腺素在很大程度上导致原发性痛经。如果患者也有避孕需求,雌孕激素制剂就成为首选药物。继发性痛经和慢性盆腔疼痛可能需要药物和手术联合治疗。口服避孕药也可用作子宫内膜异位症(盆腔疼痛最常见的原因之一)的治疗后用药,而更具特异性的化合物(促性腺激素释放激素类似物和达那唑)则用于使子宫内膜异位症发生解剖学消退。