Patient's question:
Doctor, could you please tell me, every time I have my period, it's delayed by 3 to 7 days. Also, during the first 2 days of my period, I feel lower abdominal pain, and it also feels very painful down there. What could be the reason for this? If I go to the hospital for a check-up, which tests should I have done?Doctor's answer:
Hello:Considering menstrual irregularity with blood cold type: delayed period, less volume, dark color with blood clots. Cold pain in the lower abdomen, relieved by warmth, aversion to cold, and cold limbs. White tongue, deep and tight pulse. Treatment should focus on warming the meridians and dispelling cold. Medications such as Ai Fu Nu Gong Wan (Aconite and Cinnamon Bark Pill), Tian Qi Tong Jing San (Tianqi Menstrual Pain Powder), and Jin Gui Wen Jing Wan (Golden Cabinet Warming Meridian Pill) can be used.
Causes of Dysmenorrhea
Primary dysmenorrhea is generally believed to be attributed to the following reasons: endometrial tube shedding (membranous dysmenorrhea), uterine underdevelopment, uterine flexion, cervical canal stenosis, poor posture and constitutional factors, allergic states, and psychological factors.
Secondary Dysmenorrhea
Dysmenorrhea patients with pelvic organ abnormalities detected through bimanual examination are classified as having secondary dysmenorrhea. Often, local abnormal signs may not be apparent, leading to misdiagnosis as primary dysmenorrhea. 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 very similar to primary dysmenorrhea. If the patient has progressive dysmenorrhea or a family history of endometriosis (with the mother or sister suffering from the condition), laparoscopic examination should be performed early to confirm the diagnosis and undergo conservative surgical treatment to preserve fertility.
Additionally, 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 canal stenosis, ovarian cysts, and pelvic congestion syndrome.
In addition to dysmenorrhea, elevated body temperature during menstruation should raise suspicion of pelvic inflammation.