Pain before menstruation

Pain before menstruation of varying intensity and nature disturbs half of the female population. Discomfort in the chest, abdomen is often accompanied by a depressed or nervous condition, nausea, vomiting, increased sweating and eruptions on the face. According to medical data, only 10% experience a pronounced painful syndrome.

[1], [2]

Causes of pain before menstruation

Premenstrual tenderness can be caused by various factors, among which distinguish individual features of the female body and pathology.

Causes of pain before menstruation are as follows: 

• hormonal - 7 days before the onset of menstrual changes in the hormonal background. The second part of the cycle is characterized by an overabundance of estrogen and a deficiency of progesterone; 
• "Water intoxication" - the blood content of melatonin and serotonin increases with the activation of renin-angiotensin-aldosterone (controls blood pressure and volume) system. Such changes, as well as the level of estrogen under the influence of aldosterone, lead to a process of accumulation of water and sodium in the body; 
• Prostaglandin disorders are the cause of many unpleasant symptoms. Changes in brain activity with an increase in prostaglandin E are observed in people with schizophrenia; 
• violation of neuropeptide metabolism (serotonin, dopamine, norepinephrine, etc.) - occurs at the level of the central nervous system, has a relationship with neuroendocrine processes. The interest of physicians is caused by biologically active compounds of the intermediate portion of the pituitary gland. It is established that the melanostimulating hormone of the pituitary gland in combination with beta-endorphin influences mood. Endorphin, in turn, increases the content of prolactin, vasopressin, and also slows the effect of prostaglandin E in the intestinal environment, causing flatulence, constipation, and "pouring" of the mammary glands.

Pain before menstruation develops due to abortion, manipulation of the fallopian tubes, improper contraception with hormone-containing drugs, infectious diseases, pathological course of pregnancy.

There is an assumption about the relationship of the pain syndrome that accompanies the onset of menstruation, with thyroid dysfunctions, psychoemotional disorders, malfunctions in the routine of the day, chronic lack of sleep.

[3]

Symptoms of pain before menstruation

Under the premenstrual syndrome (PMS) is understood the generality of pathologies that appear before menstruation and occur with the onset of bleeding. The syndrome is caused, first of all, by dysfunctions of the central nervous system, vegetative-vascular or metabolic-endocrine pathologies.

For PMS are characteristic: causeless irritation, weakness and dizziness, nausea, depressive state, tearfulness, manifestations of aggressive behavior, heart pain, discomfort in the chest and lower back, swelling, flatulence, shortness of breath. Some women experience inadequate behavior.

Symptoms of pain before menstruation are divided into neuropsychiatric, edematous, cephalgic and crisis manifestations.

The neuropsychiatric form is characterized by depressive conditions, increased irritability, aggression, weakness and tearfulness.

To swelling form of premenstrual syndrome include nagreganie and breast augmentation. The face, shins, fingers on arms or hand can swell. Often, women find an increased response to smells, increased sweating, bloating.

Cephalic changes include an intense, throbbing headache, often giving up to the eye area. There are soreness in the heart zone, nausea, vomiting, profuse sweating or numbness of the extremities.

The shape of the ICP is characterized by sympathetic-adrenal crises. Signs of the process are increased pressure, a pressing feeling in the chest area accompanied by fear of death and increased heart rate. Pathology manifests itself more often in the dark due to the experienced stress, severe fatigue, due to an infectious disease. Often, the end of the crisis is accompanied by active urination.

The frequency, strength and duration of symptoms distinguish between mild or severe premenstrual syndrome. The mild form has no more than 4 symptoms, of which 1-2 are clearly expressed (manifested in 2-10 days). Severe syndrome counts from 5 to 12 unpleasant conditions, with 2-5 of them being the most manifested (a maximum of 14 / at least 3 days before the onset of menstrual bleeding).

Chest pain before menstruation

Most representatives of the fair sex are familiar feeling of engorgement, increased sensitivity of the mammary glands before the onset of menstruation. The breast increases in volume, the tissues of the organ become more dense. This is due to blood loss and swelling of the glands. The cause of pain in the chest before menstruation is the change in the hormonal balance.

Periodic tenderness in the chest or mastodynia is a natural process. The mammary glands are hormone-dependent organs. Produced by the ovaries, progesterone and estradiol lead to monthly changes in the glands. The second part of the cycle proceeds under the influence of progesterone, which increases the amount of glandular tissue in the breast (preparation for pregnancy and lactation), causes its condensation. The norm is a slight soreness in the chest area.

Mastodinia is treated in combination with other symptoms - headache, blood pressure jumps, severe swelling of limbs, psychoemotional disorders, etc. Complex impact is assigned when taking into account the severity of the pain syndrome, which includes: 

• compliance with a salt-free diet with restriction of the liquid and exclusion of the products of the causative agents of the nervous system (coffee, a number of spices, strong tea, alcoholic drinks, chocolate, etc.); 
• the correct order of sleep and rest; 
• obligatory walks; 
• hardening procedures; 
• control over physical exertion; 
• effects by methods of psychotherapy; 
• drug treatment.

[4], [5], [6]

Headaches before menstruation

Reactions occurring in the body at the hormonal level cause headaches before menstruation. The appearance of pain of varying intensity before and disappearance after months is considered a normal physiological process.

Biochemical changes in the body affect the cyclicity of hormonal changes. As a result, often there are pain in the head of varying intensity, radiating into the eyeball, developing sleep disorders, dizziness, fainting.

The hormone estrogen is given the leading role in increasing the female susceptibility to stress factors, which in turn provokes the development of menstrual migraines. The process is particularly painful against the background of circulatory disorders, usually with vomiting, heightened sensitivity to light and noise. Acute seizures may appear due to the use of estrogen-containing contraceptives.

How to recognize pain before menstruation?

Painful sensations in the lower abdomen, lower back, intolerable migraines, pain in the mammary glands serve as an excuse for medical intervention.

Diagnosis of pain before menstruation is carried out by collecting complaints, gynecological examination, if necessary reinforced by additional laboratory and instrumental research.

Collection of anamnesis in case of preliminary consultation with the patient's words: 

• the period of manifestation of pain and their nature; 
• when pain was first noted; 
• information about the existence of sexual life and the achievement of orgasm; 
• characteristics of the menstrual cycle (duration, interval between two cycles, regularity); 
• presence of pain during intercourse; 
• the problem of infertility; 
• development of inflammatory diseases of the genitourinary sphere; 
• used medicines and methods of contraception.

A gynecologist's examination reveals: 

• physiological disorders in the external genitalia; 
• condition of the uterus, appendages; 
• changes in the location of internal genital organs; 
• inflammatory diseases.

Laboratory diagnosis: 

• taking smears on the flora and conducting polymerase chain reaction (PCR) tests to detect "hidden" infections; 
• bacteriological culture for the purpose of determining susceptibility to antibiotics, uroseptics; 
• checking the hormonal background in the first and / or second phase of the menstrual cycle; 
• biochemical analysis of blood, if necessary, a system of hemostasis (responsible for stopping bleeding with damage to blood vessels and maintaining blood in a liquid state); 
• analyzes for cancer markers - reflect the risk of cancers in the genital area of a woman.

Instrumental examination of pain before menstruation: 

• Ultrasound of the pelvic organs and chest; 
• mammography - X-ray method is carried out in the first phase of the month to determine the state of breast tissue.

Treatment of pain before menstruation

Treatment of pain before menstruation is based on an integrated approach and careful selection of medication, as well as the appointment of non-drug exposure individually.

Particular attention is paid to the functioning of the central nervous system, since failures in its work affect the strength of the premenstrual syndrome. The nervous balance of the body is achieved through reflex-, psychotherapy, visceral and cranial chiropractic, the application of methods of eastern therapy. Stabilizing tranquilizers and hypnotics come to the aid, which the doctor appoints individually in each specific case.

The pain syndrome is eliminated by physiotherapeutic procedures - currents, magnetic fields, laser, ultrasound, etc. These methods of treatment are selected in accordance with the age of the patient, the characteristics of her body and the existing diseases.

Discomfort in the area of the mammary glands decreases with the elimination of external stimuli - compressive, dense bras. Often used anti-inflammatory drugs of the nonsteroid group: ibuprofen, ketanol, indomethacin, suppressing the synthesis of prostaglandin. Homeopathic substances - mastodinone and cyclodinone - proved to be very useful. From the food you need to remove coffee, chocolate and monitor the amount of fluid consumed. In especially severe cases, prescription drugs that inhibit the action of the hormone prolactin, and oral combination contraceptives.

To get rid of migraines use frevatriptan and naratriptan. The drugs act only on the cause of the headache - the vessels, without exerting any influence on the pains of the other etiology. Dosage and therapeutic course is prescribed by a doctor depending on the characteristics of migraine. Some women by massaging the connective tissue of the pelvis (tentatively 5 days before the onset of menstruation) prevent the onset of a headache. Often, for the treatment of migraines use antiepileptic drugs (for example, topiramate). The combination of acetylsalicylic acid, paracetamol and caffeine has established itself as an effective tool in the fight against premenstrual migraines.

The optimal treatment of pain before menstruation is a combination of medicinal, physiotherapy techniques and manual therapy (gynecological massage).

Prevention of pain before menstruation

Prevention of pain before menstruation includes: 

• building the correct regime of the day (optimal ratio of working time and rest); 
• high-grade dream; 
• the ability to prevent stressful conditions, the absence of nervous overloads;
• choice of a healthy lifestyle (without smoking, with alcohol restriction); 
• decrease in consumption of coffee, strong tea (can enhance pain syndrome); 
• Watch your own weight (excess weight affects the manifestation of pain during menstruation); 
• the use of vegetables, fruits; 
• providing the body with vitamins A, E, B; 
• enrichment of the diet with fish, seafood, vegetable oils, soybean; 
• exercise regular physical activity to improve the elasticity and toning of the muscles; 
• water procedures are indispensable (swimming in the sea, swimming pool, etc.).

Unfortunately, pain before menstruation has become the norm. Many women obediently experience it, not noticing the alarming bells. If the pain becomes unbearable, intensifies and does not stop after the end of menstruation, you should definitely consult a specialist.