Patient's question:
Patient Gender: My menstrual cycle has always been quite irregular, accompanied by severe cramps, and heavy flow. When I was younger, the cycle was longer, but now it's usually around six or seven days. Is my condition normal?Doctor's answer:
Hello:Consider menstrual irregularities accompanied by dysmenorrhea.
Primary dysmenorrhea is generally believed to be attributed to the following reasons: endometrial shedding (membranous dysmenorrhea), uterine underdevelopment, uterine flexion, cervical stenosis, poor posture and constitutional factors, allergic states, and psychological factors, among others.
Secondary dysmenorrhea occurs when pelvic organ abnormalities are detected during bimanual examination in patients with dysmenorrhea. 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 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, 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, among others.
In addition to dysmenorrhea, elevated body temperature during menstruation should prompt consideration of pelvic inflammation. Approximately 5% of women with an intrauterine device (IUD) experience dysmenorrhea. If there is no infection, the cause of dysmenorrhea may be IUD irritation of the endometrium, leading to excessive release of prostaglandins (PGs) and excessive uterine muscle contraction.
Uterine malformations, lower genital tract obstruction...