Patient's question:
During menstruation, the lower abdomen can sometimes be very painful, accompanied by nausea. It has been a long time, and I have taken medication, but there has been no improvement. Is this considered typical menstrual cramps? How can it be improved!! Thank you!!Doctor's answer:
Hello:(1) General Treatment
Conduct necessary health education to eliminate anxiety, tension, and fear, and alleviate mental burdens. Timely treatment of chronic systemic diseases is essential. Those with developmental disorders or weak constitutions should strive to correct these issues. Begin physical exercise to enhance physical fitness. Avoid strenuous exercise and excessive fatigue during the menstrual period, prevent exposure to cold, and pay attention to menstrual hygiene.
(2) Prostaglandin Synthase Inhibitors
To reduce the release of prostaglandins, 25mg of indomethacin, 0.3g of acetylsalicylic acid, or 250mg of mefenamic acid can be taken orally 3–5 days before menstruation, with 2–4 doses per day. These may be effective.
(3) Acupuncture Treatment
During menstrual cramps, the main acupuncture points are Qihai, Hegu, and Sanyinjiao; the auxiliary points are Guanyuan, Zigong, and Zusanli. First, stimulate the main points with strong intensity, and retain the needles for 10–15 minutes. If the pain persists, add auxiliary points or moxibustion on Qihai and Guanyuan.
(4) Hormonal Treatment
1. Ovulation Suppression
Since menstrual cramps primarily occur in ovulatory cycles, oral contraceptives (Type I or II) can be tried to suppress ovulation, using the same dosage as for contraception. This may alleviate symptoms. Alternatively, 5–10mg of medroxyprogesterone, 2.5–5mg of norethisterone, or 4–8mg of megestrol can be taken orally once daily, starting on the 5th day of the menstrual cycle and continuing for 20–22 days for 3 cycles. This method is suitable for endometriosis and older individuals.
2. Estrogen
Often used for individuals with poor uterine development. 1mg of diethylstilbestrol can be taken nightly, starting on the 5th day of the menstrual cycle and continuing for 20 days, repeated for three cycles. This method can suppress ovulation and also