Secondary dysmenorrhea requires active treatment of the primary disease.
Drinking warm water, applying hot compresses to the abdomen, and taking analgesics can help relieve dysmenorrhea.
Home treatment
Hot compresses on the abdomen
You can use hot water bags and other hot compresses on the lower abdomen, which can effectively relieve dysmenorrhea. Be careful that the skin should not directly touch the hot water bag to avoid the temperature being too high.
Adjustment of lifestyle
Do not take a bath during menstruation, and strenuous exercise is not recommended. Ensure sufficient rest and pay attention to keeping warm.
Symptomatic treatment
Some patients with dysmenorrhea can be treated with oral analgesics, such as ibuprofen and ketoprofen, which can effectively relieve pain. Certain herbs, such as angelica and fennel, can also relieve dysmenorrhea. All the above medicines are recommended to be used under medical supervision.
Treatment of causes
Treatment of causes is required after identifying the cause. For example:
Primary dysmenorrhea
General treatment: Eliminate tension and anxiety can relieve pain; ensure enough rest and sleep, regular and moderate exercise, quit smoking.
Medication: Commonly used drugs include ibuprofen, ketoprofen, meclofenamic acid, diclofenac, mefenamic acid, naproxen, and birth control pills.
Endometriosis
Drug therapy: for patients with chronic pelvic pain, obvious symptoms of dysmenorrhea during menstruation, fertility requirements and no ovarian cyst formation. Commonly used drugs are non-steroidal anti-inflammatory drugs, contraceptives (clinically commonly used low-dose high-efficiency progesterone and ethinyl estradiol complex preparations), progesterone (such as methylated hydroxyprogesterone), progesterone receptor antagonists (such as mifepristone), pregnenolone, danazol, and gonadotropin-releasing hormone agonists (such as leucovorin), and so on.
Surgery: it is suitable for those who do not have symptomatic relief after drug treatment, those whose localized lesions have worsened or whose reproductive function has not been restored, and those who have large ovarian endometriotic cysts. Laparoscopic surgery is the surgical method of choice. Surgical procedures include fertility preservation surgery and ovarian function preservation surgery.
Uterine adenomyosis
Medication: there is no curative and effective medication. Patients with mild symptoms, fertility requirements and near menopause can be treated with danazol, progesterone and levonorgestrel intrauterine extended-release system.
Surgical treatment: young patients or those who wish to have children can try lesion excision. Those with severe symptoms, no fertility requirements or ineffective drug treatment should undergo total hysterectomy. Whether or not the ovaries are preserved depends on the presence or absence of lesions on the ovaries and the age of the patient.
Uterine fibroids
Observation: asymptomatic fibroids usually do not require treatment, and it is recommended that they be followed up every 3 to 6 months, and further treatment may be considered if symptoms develop.
Medication: It is suitable for those who have mild symptoms, near menopausal age, or whose general condition is not suitable for surgery. Commonly used drugs include gonadotropin-releasing hormone analogs and mifepristone.
Surgical treatment: for serious conditions (such as secondary anemia, severe abdominal pain, pressure on the bladder and other peripheral organs, suspected sarcomatous changes, infertility or repeated miscarriages), commonly used surgical procedures include myomectomy, hysterectomy, and so on. Surgery can be performed transabdominally, transvaginally or with hysteroscopy and laparoscopy.
Other treatments: mainly for those who can not tolerate or do not want to surgery, feasible interventional therapy, such as uterine artery embolization.