Why does a 35-year-old woman have stomach pain during menstruation?

Abdominal pain during menstruation in a 35-year-old woman may be caused by primary dysmenorrhea, endometriosis, pelvic inflammatory disease, adenomyosis, ovarian cysts, etc. It can be relieved by hot compress, drug analgesia, hormone therapy, surgery, etc.

1. Primary dysmenorrhea

Excessive secretion of prostaglandins causes excessive uterine contractions, which manifests as spasmodic pain in the middle of the lower abdomen on the 1st to 2nd day of menstruation, which may be accompanied by nausea and vomiting. It is recommended to use non-steroidal anti-inflammatory drugs such as ibuprofen sustained-release capsules and acetaminophen tablets, together with abdominal hot compress to relieve symptoms.

2. Endometriosis

Ectopic endometrial tissue bleeds with the menstrual cycle and stimulates the pelvic cavity. The pain usually starts 1-2 days before menstruation and lasts throughout the menstrual period. It is often accompanied by dyspareunia and infertility. Laparoscopy is required to confirm the diagnosis, and drugs such as dienogest tablets and goserelin sustained-release implants can be used as directed by the doctor to inhibit intimal growth.

3. Pelvic inflammatory disease

When pathogenic ascending infection causes fallopian tube and ovarian abscess, persistent lower abdominal pain accompanied by fever and increased vaginal discharge will occur. Gynecological examination and ultrasound need to be improved, and ceftriaxone sodium for injection combined with metronidazole and sodium chloride injection should be used for anti-infective treatment in the acute stage.

4. Adenomyosis

The endometrium invades the myometrium, causing the uterus to enlarge uniformly, typically manifesting as progressively aggravated menstrual abdominal pain and increased menstrual flow. Ultrasound shows honeycomb changes in the myometrium, and levonorgestrel intrauterine sustained-release system or hysterectomy may be considered.

5. Ovarian cysts

Severe abdominal pain may occur when a corpus luteum cyst or endometrioid cyst ruptures during menstruation, and may be accompanied by symptoms of shock. Emergency ultrasound can confirm the diagnosis, and if necessary, laparoscopic cyst removal is required.

During menstruation, you should pay attention to keeping the abdomen warm and avoid strenuous exercise and cold or cold foods. Drinking ginger brown sugar water every day can help relieve uterine cold dysmenorrhea. Record the duration, degree and accompanying symptoms of pain. If there is non-menstrual pain, abnormal bleeding or pain that affects daily life, it is recommended to go to a gynecologist in time to complete pelvic ultrasound, CA125 and other examinations. After excluding organic diseases, it can be combined with traditional Chinese medicine acupuncture or moxibustion at Guanyuan, Sanyinjiao and other acupoints for conditioning.