Patient's question:
Hello, I am 25 years old and unmarried. Since I started my period (at 17), I have been experiencing lower abdominal pain. When it first started, the pain lasted for as many days as my period did. However, after trying many traditional Chinese medicines, Western medicines, and some home remedies, the pain has reduced from lasting for several days to just a few hours. But if I don't take any measures, it's still the same as before. During my period, I feel very sleepy, my thighs swell, as if all the blood in my body is being poured into them. Sometimes I also feel nauseous. When I sleep, I get very hot under the blanket, but if I remove a bit of it, I feel very cold—it's always either too hot or too cold.Doctor's answer:
Hello: This should be primary dysmenorrhea.Precautions and treatment for dysmenorrhea?
After identifying the possible causes of dysmenorrhea through medical history and physical examinations, the following treatments are recommended:
(1) General Treatment
Conduct necessary health education to eliminate anxiety, tension, and fear, and relieve mental burdens. Timely treatment of chronic systemic diseases is necessary. Those with developmental issues or weak constitutions should correct these conditions. Begin physical exercise to enhance physical fitness. Avoid strenuous exercise and excessive fatigue during menstruation, prevent cold exposure, and pay attention to menstrual hygiene.
(2) Prostaglandin Synthetase Inhibitors
To reduce prostaglandin release, take 25mg of indomethacin, 0.3g of acetylsalicylic acid, or 250mg of mefenamic acid orally 3–5 days before menstruation. Dosage: 2–4 times daily. This may be highly effective.
(3) Acupuncture Treatment
During dysmenorrhea attacks, the main acupoints are Qihai, Hegu, and Sanyinjiao. The auxiliary acupoints are Guanyuan, Zongzi, and Zusanli. First, stimulate the main acupoints with strong intensity, retain the needles for 10–15 minutes. If the pain persists, add auxiliary acupoints or moxibustion on Qihai and Guanyuan.
(4) Hormonal Treatment
1. Ovulation Suppression
Since dysmenorrhea primarily occurs in ovulatory cycles, try taking Contraceptive Pill I or II to suppress ovulation. The dosage is the same as for contraception, which may alleviate symptoms. Alternatively, take 5–10mg of medroxyprogesterone daily, 2.5–5mg of norethisterone, or 4–8mg of megestrol daily. Begin on the 5th day of the menstrual cycle and take for 20–22 days, for 3 cycles in total. This is effective for endometriosis and those with longer menstrual cycles.