A 35 -year -old uterine endometriosis woman came to consult with pregnancy.It shows that she is not trying to get pregnant, just to treat dysmenorrhea, and wants to help doctors help and get pregnant as soon as possible.
Treatment of dysmenorrhea with pregnancy?
I have endometriosis and severe dysmenorrhea.Every time it hurts to death.I don’t want to remove the uterus. It is said that pregnancy is the best treatment.
Seeing that she is a rigorous woman with knowledge, she has done her homework when she came to the clinic.
I have done a public welfare question and answer about dysmenorrhea. Many women’s descriptions of dysmenorrhea are "painful" and "every time menstruation wants to take a ghost door"!It can be seen how the influence of dysmenorrhea on women’s quality of life.
Yes, five "best treatments" (Best Therapy) are proposed at the International Conference of the International Internal Affairs (Quebec, Canada), that is, laparoscopy is the best treatment, ovarian suppression is the best treatment, "three stages" (three stages "(three stages" (Surgery → Drug Treatment → Ortoscopic surgery again) is the best treatment for treatment, pregnancy is the best treatment, and pregnancy -aged technology is the best treatment.Among them, there is the theory of pregnancy treatment.
1. Why does the endometriosis hurt
Dysmenorrhea is the most prominent clinical manifestation of endometriosis.Words used to describe dysmenorrhea are often like this: secondary sexuality, aggravation of sexuality.Severe dysmenorrhea is related to the degree of infiltration of the abnormal lesion. The lesions located in the uterine rectal nests and the citrium ligaments often cause severe dysmenorrhea.
The cause of dysmenorrhea is not very clear, the following points may be:
① The endometrium of the abnormal uterine also has periodic changes under the influence of ovarian hormones, similar to bleeding during menstrual periods.The repeated periodic bleeding of the ectopic endometrium causes pathological progress, stimulating local tissue and causing pain;
② The endometrium of the endometrium in the normal position will produce a substance (PGS) called prostaglandin. The uterus is affected by excessive contraction, the blood flow of the uterine blood decreases, and local ischemia causes pain;
③ The endometrial lesions in the abnormal level can cause inflammatory reactions, causing pain in other peptide substances.
2. How to judge the degree of dysmenorrhea
Pain is a subjective feeling of patients. Therefore, the evaluation of the strength of the pain does not have an objective instrument to choose from, and it mainly depends on the subjective description of the patient.Everyone’s pain threshold is different, and the degree of tolerance to pain is different.There are two methods of evaluation of pain clinically.
① Table method.Evaluation Pain is commonly used in language evaluation tables (VDS), facial pain expression tables (FPS-R), main complaint pain grading method (VRS), visual vague score (VAS), digital evaluation table (NRS), etc.Although there are many methods, it is cumbersome, but it is rarely applied in clinical work.
② Experience diagnosis method.Most clinically, the patient’s dysmenorrhea is indirectly understood.For example, according to the degree of impact on work, study and daily life, are divided into mild, moderate and heavy.Or ask the patient if you need to take painkillers and whether analgesic drugs are valid, so as to understand the degree of dysmenorrhea and whether to intervene.
Mild: Do not affect work, life;
Moderate: affect work and not affect life;
Severe: severe pain, affecting work and life.
It is worth noting that not everyone has dysmenorrhea, and about 1/4 of patients with internal diseases have no obvious dysmenorrhea.And the degree of dysmenorrhea is mostly subjective judgment, which is related to the degree of tolerance and psychological state.In addition, the degree of dysmenorrhea is not necessarily positively related to the scope of the disease.
3. Why can pregnancy treat internal disease (dysmenorrhea)
Endometriosis is a hormone -dependent disease and organ dependencies.Its occurrence is related to estrogen and ovarian function.This can explain why this disease rarely happened before adolescence.Inhibiting ovarian function and inhibiting ovulation can achieve the purpose of alleviating dysmenorrhea.Therefore, the amenorrhea during breastfeeding is the best treatment for internal diseases, and pregnancy is a physiological process.
"Fake Pregnancy therapy" in the 1960s; "Fake Persistence" in the 1970s.Since 1980, the adenomanoplasm release agent (GNRHA) was released and used in the treatment of internal diseases, as well as the application of short -acting contraceptives, the purpose lies in this.
Fourth, pregnancy cure dysmenorrhea?Is it reliable?
I think it is not reliable.
The reason for reliable is as mentioned above.The reason that is not reliable is that if there are no fertility requirements, internal diseases are treated, and there are many better ways to treat dysmenorrhea caused by internal diseases. There is no need to use the method of motioning and dry in pregnancy.Moreover, 30%-50%of patients with internal diseases have fertility disorders, and some infertility of unknown causes is also related to internal diseases. It is easy to talk about treatment through pregnancy!
Say important things again, please feel at your heart!If there are fertility requirements, primary things are on pregnancy.The purpose of pregnancy is not to treat dysmenorrhea, to discover the situation that cannot be pregnant in time, and to find out whether you are patients with 30%-50%of patients with fertility internal disease in time in order to treat them in time.Timely discovery and timely treatment means calmly face it.
5. What should this 35 -year -old woman do?
35 years old is already an old age.My advice:
① Facing your own heart (do you want to be a permanent Dink, or want to be a mother);
② Follow your own problems (for many years of marriage, contraception is too successful, it is not necessarily a good thing, and it has been diagnosed as an internal disease);
③ Do it related to the age (everything involves things related to age, don’t better not be late);
④ If you are still in contraception, it is recommended to relieve contraceptive measures as soon as possible. If you are not pregnant for 6-12 months, it is recommended to actively intervene in the examination.
Dysmenorrhea is not terrible. Few people simply take uterine resection or uterine and bilateral attachment resection for dysmenorrhea.Most women can choose a treatment method that suits them by consulting, communicating, and rationally facing the doctor.
Author introduction: Gao Qin, chief physician of the reproductive center affiliated to the Reproductive Hospital Affiliated to Shandong University.30 points (except for statutory holidays and special circumstances) I will answer the questions for my fans for free, so stay tuned.
