Patient's question:
I always have severe pain during my period, sometimes twice a month, what should I do?Doctor's answer:
Hello: Dysmenorrhea is defined as lower abdominal pain during menstruation or in the days before or after menstruation, which affects work or health. It can be classified into primary and secondary dysmenorrhea. For secondary dysmenorrhea, etiological treatment should be administered. For primary dysmenorrhea, when the pain is severe, "Atropine" 0.5 mg can be given intramuscularly, or symptomatic treatment can be provided using analgesics such as "Aspirin." Progestogen therapy can also be used, such as taking "Etonogestrel" 2.5–5 mg or "Medroxyprogesterone" 4–8 mg orally once daily, starting on the 5th day of the menstrual cycle, and continuing for 22 days, for 3 cycles. Alternatively, "Progesterone" 10–20 mg can be injected intramuscularly once daily, starting 7 days before menstruation, and administered for 5 days. Estrogen therapy, such as taking "Diethylstilbestrol" 0.5–1 g orally once daily, starting on the 6th day of the menstrual cycle, and continuing for 20 days, can also be chosen.Traditional Chinese Medicine classifies dysmenorrhea into the following four types based on etiology and treats each according to syndrome differentiation.
Qi Stagnation and Blood Stasis: Pain in the lower abdomen before or during menstruation, intermittent cramping with resistance to pressure, or accompanied by distension in the chest, breasts, and nipple tenderness, irritability, reduced menstrual volume or irregular flow, dark purple menstrual blood with clots, and a dark purple tongue with petechiae. For this type, Chinese patent medicines that promote liver qi, regulate qi, and resolve blood stasis should be used, such as "Desheng Dan," 1–2 pills per dose, taken twice daily with warm water; or "Women's Menstrual Regulation Pills," 9 g per dose, taken twice daily with warm water.
Yang Deficiency and Internal Cold: Cold pain in the lower abdomen during or after menstruation, relief with warmth and pressure, and alleviation of pain when warmed. The menstrual blood is pale and scant, accompanied by lower back and leg weakness, and cold hands and feet.