Patient's question:
What factors cause pain? What do a widened vaginal opening and endometrial displacement mean?Doctor's answer:
Hello: Primary dysmenorrhea is generally believed to be attributed to the following several reasons: endometrial shedding (membranous dysmenorrhea), uterine hypoplasia, uterine flexion, cervical stenosis, poor posture and constitutional factors, allergic states, and psychological factors, etc.Secondary dysmenorrhea refers to dysmenorrhea in patients where pelvic organ abnormalities are detected through bimanual examination. It is often misdiagnosed as primary dysmenorrhea when local abnormal signs are not yet apparent. Therefore, for dysmenorrhea that begins more than 3 years after menarche, secondary dysmenorrhea should be considered, and further examination is necessary.
The most common cause of secondary dysmenorrhea in young women is endometriosis, which has symptoms extremely similar to primary dysmenorrhea. If the patient has progressive dysmenorrhea or a family history of endometriosis (with the mother or sisters suffering from the condition), laparoscopic examination should be performed early to confirm the diagnosis and undergo conservative surgical treatment to preserve fertility.
Additionally, the causes of secondary dysmenorrhea include congenital uterine malformations (including bicornuate uterus, septate uterus, unicornuate uterus, transverse vaginal septum, etc.), pelvic inflammation, adenomyosis, uterine fibroids, uterine polyps, uterine adhesions, cervical stenosis, ovarian cysts, and pelvic congestion syndrome, etc.
In addition to dysmenorrhea, if there is a rise in body temperature during menstruation, pelvic inflammation should be considered. Approximately 5% of women with an intrauterine device (IUD) experience dysmenorrhea. If there is no infection, the cause of dysmenorrhea may be the IUD stimulating the endometrium, leading to excessive release of PGs and resulting in overly strong uterine muscle contractions.
Patients with uterine malformations or complete obstruction of the lower reproductive tract may experience cyclical lower abdominal pain. The age of menarche has already