Pain before menstruation

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

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Causes of pain before menstruation

Premenstrual pain can be caused by various factors, including individual characteristics of the female body and pathologies.

The causes of pain before menstruation are as follows:

• hormonal - 7 days before the onset of menstruation, changes in the hormonal background are noted. The second part of the cycle is characterized by an excess of estrogen and a deficiency of progesterone;
• "water intoxication" - the content of melatonin and serotonin in the blood increases with the activation of the renin-angiotensin-aldosterone system (controls blood pressure and blood volume). Such changes, as well as the level of estrogen under the influence of aldosterone, lead to the 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 patients with schizophrenia;
• neuropeptide metabolism disorder (serotonin, dopamine, norepinephrine, etc.) – occurs at the level of the central nervous system and is interconnected with neuroendocrine processes. Biologically active compounds of the intermedial pituitary gland are of interest to physicians. It has been established that the melanocyte-stimulating hormone of the pituitary gland in combination with beta-endorphin affects mood. Endorphin, in turn, increases the content of prolactin, vasopressin, and also slows down the effect of prostaglandin E in the intestinal environment, which causes flatulence, constipation, and "filling" of the mammary glands.

Pain before menstruation develops as a result of abortion, manipulation of the fallopian tubes, improper contraception with hormonal drugs, infectious diseases, and pathological course of pregnancy.

There is a hypothesis about the relationship between the pain syndrome that accompanies the onset of menstruation, dysfunctions of the thyroid gland, psycho-emotional disorders, disruptions in the usual daily routine, and chronic lack of sleep.

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Symptoms of pain before menstruation

Premenstrual syndrome (PMS) is a group of pathologies that appear before menstruation and disappear 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.

PMS is characterized by: unreasonable irritation, weakness and dizziness, nausea, depression, tearfulness, aggressive behavior, heart pain, discomfort in the chest and lower back, swelling, flatulence, shortness of breath. Some women experience inappropriate behavior.

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

The neuropsychic form is characterized by depressive states, increased irritability, aggression, weakness and tearfulness.

The edematous form of premenstrual syndrome includes engorgement and enlargement of the breasts. The face, shins, and fingers may swell. Women often experience increased sensitivity to odors, increased sweating, and bloating.

Cephalgic changes include intense, throbbing headaches, often radiating to the eye area. There is pain in the heart area, nausea, vomiting, profuse sweating, or numbness in the extremities.

The crisis form of PMS is characterized by sympathetic-adrenal crises. The signs of the process are increased pressure, a pressing sensation in the chest area, accompanied by fear of death and increased heart rate. The pathology manifests itself more often in the dark due to stress, severe fatigue, or an infectious disease. Often, the end of the crisis is accompanied by active urination.

Based on the frequency, strength and duration of symptoms, premenstrual syndrome is classified as mild or severe. Mild forms include no more than 4 symptoms, of which 1-2 are clearly expressed (appear 2-10 days before). Severe syndrome includes 5 to 12 unpleasant conditions, with 2-5 of them being the most pronounced (appearing a maximum of 14/minimum of 3 days before the onset of menstrual bleeding).

Breast pain before menstruation

Most of the fair sex are familiar with the 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 denser. This is due to blood flow and swelling of the glands. The reason causing chest pain before menstruation is a change in hormonal balance.

Periodic breast pain or mastodynia is a natural process. The mammary glands are hormone-dependent organs. Progesterone and estradiol produced by the ovaries cause monthly changes in the glands. The second part of the cycle occurs under the influence of progesterone, which increases the amount of glandular tissue in the breast (preparation for pregnancy and lactation), causing it to become denser. Slight pain in the breast area is normal.

Mastodynia is treated in combination with other symptoms - headache, blood pressure surges, severe swelling of the extremities, psycho-emotional disorders, etc. Complex treatment is prescribed taking into account the severity of the pain syndrome, including:

• following a salt-free diet while limiting fluids and excluding foods that stimulate the nervous system (coffee, a number of spices, strong tea, alcoholic beverages, chocolate, etc.);
• proper sleep and rest schedule;
• mandatory walks;
• hardening procedures;
• control over physical activity;
• influence by psychotherapeutic methods;
• drug treatment.

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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 its disappearance after menstruation is considered a normal physiological process.

Biochemical changes in the body affect the cyclicity of hormonal shifts. As a result, headaches of varying intensity often appear, radiating to the eyeball, sleep disorders, dizziness, and fainting develop.

The hormone estrogen plays a leading role in increasing women's susceptibility to stress factors, which in turn provoke the development of menstrual migraine. The process is especially painful against the background of circulatory disorders, usually with vomiting, heightened sensitivity to light and noise. Acute attacks may occur as a result of taking estrogen-containing contraceptives.

How to recognize pain before menstruation?

Pain in the lower abdomen, lower back, unbearable migraines, pain in the mammary glands are the reason for medical intervention.

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

Collection of anamnesis during a preliminary consultation from the patient's words:

• the period of manifestation of pain and its nature;
• when the pain syndrome was first noted;
• information about the presence of sexual activity and achieving orgasm;
• characteristics of the menstrual cycle (duration, interval between two cycles, regularity);
• presence of pain during sexual intercourse;
• infertility problem;
• development of inflammatory diseases of the genitourinary system;
• medications and contraceptive methods used.

A gynecological examination reveals:

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

Laboratory diagnostics:

• taking smears for flora and conducting polymerase chain reaction (PCR) tests to detect “hidden” infections;
• bacteriological culture to determine sensitivity to antibiotics and uroseptics;
• checking hormonal levels in the first and/or second phase of the menstrual cycle;
• biochemical blood test, if necessary, hemostasis system (responsible for stopping bleeding when blood vessels are damaged and maintaining blood in a liquid state);
• tests for oncological markers – show the risk of cancerous growths in the female reproductive system.

Instrumental examination of pain before menstruation:

• Ultrasound of the pelvic organs and chest;
• Mammography is an X-ray method performed in the first phase of menstruation to determine the condition of breast tissue.

Treatment for Premenstrual Pain

Treatment of pain before menstruation is based on a comprehensive approach and careful selection of medication, as well as the appointment of non-drug treatment on an individual basis.

Particular attention is paid to the functioning of the central nervous system, since failures in its work affect the strength of premenstrual syndrome. The nervous balance of the body is achieved through reflexotherapy, psychotherapy, visceral and cranial chiropractic, and the use of oriental therapy techniques. Stabilizing tranquilizers and sleeping pills come to the rescue, which are prescribed by the doctor individually in each specific case.

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

Discomfort in the mammary glands is reduced by eliminating external irritants - constricting, tight bras. Non-steroidal anti-inflammatory drugs are often used: ibuprofen, ketanol, indomethacin, which suppress prostaglandin synthesis. Homeopathic substances - mastodinone and cyclodinone - have proven themselves well. Coffee and chocolate should be eliminated from the diet and the amount of liquid consumed should be monitored. In particularly severe cases, drugs that suppress the action of the hormone prolactin and oral combined contraceptives may be prescribed.

Frovatriptan and naratriptan are used to get rid of migraines. The drugs act only on the cause of the headache - the vessels, without having any effect on pain of other etiologies. The dosage and therapeutic course are prescribed by the doctor depending on the characteristics of the migraine. Some women prevent headaches by massaging the connective tissue of the pelvis (approximately 5 days before the onset of menstruation). Antiepileptic drugs (for example, topiramate) are often used to treat migraines. A combination of acetylsalicylic acid, paracetamol and caffeine has proven itself as an effective means in the fight against premenstrual migraines.

The optimal treatment for premenstrual pain is a combination of medication, physical therapy and manual therapy (gynecological massage).

Preventing Pain Before Menstruation

Prevention of premenstrual pain includes:

• building the correct daily routine (optimal balance between work time and rest);
• good sleep;
• the ability to prevent stressful conditions, absence of nervous overload;
• choosing a healthy lifestyle (no smoking, limited alcohol consumption);
• reducing consumption of coffee and strong tea (they can increase pain);
• monitor your own weight (excess weight affects the manifestation of pain during menstruation);
• consumption of vegetables and fruits;
• providing the body with vitamins A, E, B;
• enriching the diet with fish, seafood, vegetable oils, soy;
• performing regular physical activity to improve muscle elasticity and tone;
• Water treatments are irreplaceable (swimming in the sea, pool, etc.).

Pain before menstruation has unfortunately become the norm. Many women meekly endure it, not noticing the alarm bells. If the pain becomes unbearable, intensifies and does not stop after the end of menstruation, you should definitely consult a specialist.