Understanding Menstrual Pain
Deep dive into the causes, types, and physiological mechanisms of menstrual pain to lay a scientific foundation for effective management.
What is Menstrual Pain?
Dysmenorrhea refers to lower abdominal pain, cramping, or discomfort that occurs during or around menstruation. It is one of the most common gynecological symptoms, affecting approximately 80% of women of reproductive age worldwide.
The severity of menstrual pain varies from person to person, ranging from mild discomfort to severe pain that significantly impacts daily life. Understanding the nature of menstrual pain is the first step in developing effective management strategies.
Types of Menstrual Pain
Primary Dysmenorrhea
Primary dysmenorrhea is the most common type, usually appearing shortly after the onset of puberty. This pain is caused by uterine contractions and has no underlying pathological cause.
- Usually appears 1-2 days before menstruation begins
- Pain concentrated in lower abdomen and lower back
- May be accompanied by nausea, vomiting, diarrhea
- Pain lasts 1-3 days
Secondary Dysmenorrhea
Secondary dysmenorrhea is caused by underlying gynecological conditions, usually appearing in adulthood or when existing pain suddenly worsens. Requires medical evaluation and treatment.
- May be caused by endometriosis
- Uterine fibroids or adenomyosis
- Pelvic inflammatory disease
- Requires professional medical diagnosis
Physiological Mechanisms
Role of Prostaglandins
Prostaglandins are the primary biochemical factors causing menstrual pain. During menstruation, the endometrium releases large amounts of prostaglandins, particularly PGF2α and PGE2, which cause strong uterine muscle contractions, compress blood vessels, reduce blood flow, and thus generate pain.
Pain Transmission Pathways
Menstrual pain signals are transmitted through the sympathetic nervous system to the spinal cord and then to the brain. This process involves multiple neurotransmitters and receptors, including endorphins and serotonin, which explains why certain treatments (such as exercise and meditation) can effectively relieve pain.
Traditional Chinese Medicine Analysis
Based on symptom characteristics, Traditional Chinese Medicine categorizes menstrual pain into several main syndrome types, each with unique pathological mechanisms and treatment approaches:
🌪️ Qi Stagnation and Blood Stasis
Main Symptoms: Distending pain, stabbing pain, dark menstrual blood with clots
Pain Characteristics: Fixed location, worse with pressure
Treatment Principle: Soothe liver qi, activate blood circulation
❄️ Cold Coagulation and Blood Stasis
Main Symptoms: Cold pain, cramping pain, relieved by warmth
Pain Characteristics: Worsened by cold
Treatment Principle: Warm meridians, dispel cold, activate blood
💧 Qi and Blood Deficiency
Main Symptoms: Dull pain, bearing-down pain, likes pressure
Pain Characteristics: Continuous and lingering
Treatment Principle: Tonify qi and blood, nourish blood to stop pain
🌙 Liver and Kidney Deficiency
Main Symptoms: Dull pain, soreness in lower back and knees
Pain Characteristics: With empty falling sensation
Treatment Principle: Nourish liver and kidney, regulate Chong and Ren meridians
Advantages of Integrative Medicine
Modern medicine's prostaglandin theory and TCM's qi-blood theory complement each other. Western medicine's rapid pain relief combined with TCM's holistic regulation can achieve both symptomatic and root treatment, relieving acute pain while improving constitution and reducing recurrence.
Medical Treatment and Professional Intervention
Medication Options
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- • Ibuprofen, Naproxen, etc.
- • Inhibit prostaglandin synthesis
- • Rapid pain and inflammation relief
Hormonal Therapy
- • Oral contraceptives
- • Regulate hormone levels
- • Reduce endometrial thickness
When to Seek Medical Help
Emergency Medical Signs
- • Sudden severe abdominal pain with nausea/vomiting
- • Pain with fever (>38.5°C)
- • Heavy vaginal bleeding
- • Pain with fainting or shock symptoms
Elective Medical Consultation
- • New onset or changed pattern of pain
- • Progressive worsening of pain
- • Regular painkillers ineffective
- • Severely affecting daily life and work
Professional Examination Items
Basic Examinations
- • Detailed medical history
- • Gynecological examination
- • Pelvic ultrasound
Further Examinations
- • Blood tests, inflammation markers
- • Tumor marker testing
- • Pelvic MRI examination
Special Examinations
- • Hysteroscopy
- • Laparoscopy
- • Histopathological examination
Risk Factors
Physiological Factors
- Age under 30
- Early menarche
- Shorter menstrual cycles
- Heavy menstrual flow
Lifestyle Factors
- Lack of exercise
- High stress levels
- Poor dietary habits
- Smoking
Genetic Factors
- Family history of dysmenorrhea
- Genetic susceptibility
- Hormone sensitivity
Menstrual Pain Comparison and Differential Analysis
Menstrual Pain vs Other Abdominal Pain
| Pain Type | Pain Characteristics | Timing | Associated Symptoms |
|---|---|---|---|
| Menstrual Pain | Cyclical cramping pain, mainly lower abdomen | Before or during menstruation | Nausea, headache, fatigue |
| Pregnancy Cramps | Mild cramping, usually gentle | Early pregnancy | Nausea, breast tenderness, fatigue |
| Labor Contractions | Intense, regular cramping | Late pregnancy | Back pain, pressure, bloody show |
Comparison of Different Menstrual Pain Therapies
Pharmaceutical Therapy
Non-Pharmaceutical Therapy
East vs West: Menstrual Pain Relief Wisdom
Eastern Traditional Medicine
- • Holistic regulation, treating both symptoms and root causes
- • Individualized syndrome differentiation
- • Acupuncture, herbal medicine, dietary therapy
- • Prevention-focused, emphasizing conditioning
Western Modern Medicine
- • Evidence-based medicine, precision treatment
- • Rapid pain relief, clear effects
- • Pharmaceutical and physical therapy
- • Standardized treatment protocols
💡 Best Practice: Combine Eastern and Western wisdom - Western medicine for rapid acute pain relief, Traditional Chinese Medicine for long-term conditioning to improve constitution, achieving personalized comprehensive treatment plans.
When to Seek Medical Help
Please consult a healthcare professional promptly if you experience:
- Pain severely affects daily life and work
- Pain pattern suddenly changes or worsens
- Accompanied by abnormal bleeding or discharge
- Over-the-counter medications cannot relieve pain