Is there any relationship between severe dysmenorrhea and uterine fibroids?

Severe dysmenorrhea may be related to uterine fibroids. Dysmenorrhea is divided into two categories: primary and secondary. Uterine fibroids are one of the common causes of secondary dysmenorrhea. Other possible factors include pelvic inflammatory disease, endometriosis and other hormone-related diseases.

1. Uterine fibroids

Uterine fibroids are benign tumors formed by the proliferation of uterine smooth muscle tissue. When the fibroids are located close to the endometrium or are large in size, they may compress the uterine cavity or affect the contraction function of the uterus, causing menstrual pain to worsen. Typical symptoms include increased menstrual flow, prolonged menstrual periods, and a feeling of bloating in the lower abdomen. Confirmation requires ultrasound or magnetic resonance imaging. Treatment options include mifepristone tablets, Guizhi Fuling capsules and other drugs to inhibit the growth of fibroids, or surgery such as uterine myomectomy.

2. Pelvic inflammatory disease

Pelvic adhesions caused by chronic pelvic inflammatory disease may cause increased pelvic congestion during menstruation, manifesting as persistent lower abdominal pain that radiates to the lumbosacral region. It may be accompanied by symptoms such as fever and abnormal discharge. The diagnosis needs to be confirmed through gynecological examination and secretion culture. Antibiotics such as levofloxacin tablets and metronidazole vaginal effervescent tablets are commonly used, supplemented by pelvic physiotherapy to promote the absorption of inflammation.

3. Endometriosis

Active endometrium tissue grows ectopically outside the uterine cavity, and the bleeding lesions stimulate surrounding tissues during menstruation, causing progressively worsening dysmenorrhea. It is often accompanied by symptoms such as dyspareunia and infertility. Laparoscopy is the diagnostic gold standard. Treatment options include ethinyl estradiol cyproterone tablets, Sanjie Analgesic Capsules and other drugs, or lesion resection.

4. Intrauterine device stimulation

In some women, the insertion of a copper-containing intrauterine device may stimulate uterine contractions and worsen menstrual cramps, which usually occur within 3-6 months after the device is inserted. The position of the IUD can be confirmed through ultrasound, and if necessary, it can be replaced with a progestin-containing type such as a levonorgestrel sustained-release intrauterine system, or ibuprofen sustained-release capsules can be taken orally to relieve pain.

5. Primary dysmenorrhea

Primary dysmenorrhea without organic disease is mostly caused by excessive secretion of prostaglandins during menstruation, which triggers excessive uterine contractions. It is common in adolescents 1-2 years after menarche. The pain is spasmodic and concentrated 48 hours before menstruation. It can be relieved by applying hot compresses and taking prostaglandin synthase inhibitors such as diclofenac sodium enteric-coated tablets.

It is recommended that people with severe dysmenorrhea record pain characteristics and menstrual cycle changes, and avoid strenuous exercise and cold foods during menstruation. When long-term dysmenorrhea affects the quality of life, gynecological ultrasound, hormone level testing and other examinations should be carried out promptly. After organic diseases are ruled out, short-acting contraceptives or traditional Chinese medicine can be used as directed by the doctor. Keeping the abdomen warm every day and supplementing with appropriate amounts of vitamin B1 and magnesium preparations may help reduce muscle spasms.