Primary Dysmenorrhea: Assessment and Treatment

Abstract Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments’ contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.

摘要 原发性痛经（Primary dysmenorrhea）指无盆腔器质性病变的经期疼痛。其核心病理为子宫内膜前列腺素过度合成，引发子宫过度收缩，进而导致子宫肌层缺血、缺氧，最终诱发疼痛。该病是育龄女性最常见的妇科疾病，亦是盆腔疼痛的最常见诱因之一；然而，其常存在诊断不足、治疗不充分的情况，甚至不少女性将其视作经期的正常表现而未予足够重视。原发性痛经对生活质量存在显著负面影响，可限制日常活动、引发心理应激，是导致学生缺课、职场缺勤的主要原因之一。其诊断主要依托临床判断，基于病史采集与体格检查结果正常，需注意排除继发性痛经的致病因素。治疗方案可分为药物治疗、非药物治疗与手术治疗三大类，一线治疗方案为非甾体抗炎药（NSAIDs）；对于有避孕需求的女性，可选用激素类避孕药。若患者存在常规治疗的禁忌证，则可选择局部热敷、调整生活方式、经皮神经电刺激、膳食补充剂、针灸及指压按摩等替代疗法。手术治疗仅适用于极少数经规范治疗无效的重度痛经患者。

搜集汇总

背景与挑战

背景概述

该数据集聚焦于原发性痛经的临床评估与治疗，包含病因分析、诊断标准及多种治疗方法的介绍。数据集提供了相关研究材料和关键词，适用于妇产科领域的研究。