高明论坛畅谈高明:疾病大全：痛经

Menstrual cramps (dysmenorrhea) are dull, throbbing or cramping pains in the lower abdomen. Many women experience menstrual cramps just before and during their menstrual periods. For some women, the discomfort is merely annoying. For others, it can be severe enough to interfere with everyday activities for a few days every month.

Menstrual cramps may be caused by identifiable problems, such as endometriosis or uterine fibroids. Treating the underlying cause is key to reducing the pain. Menstrual cramps that aren't caused by some underlying condition tend to lessen with age and often disappear once a woman has given birth.

　　痛经的原因是可寻的，比如说子宫内膜异位或子宫平滑肌瘤。治疗内在病因对缓解疼痛很重要。非内在原因而引起的痛经会随着年龄的增大而减轻或者在妊娠之后消失。

Symptoms

症状

By Mayo Clinic staff

By Mayo Clinic staff

Symptoms of menstrual cramps include:

痛经的症状包括：

Dull, throbbing or cramping pain in your lower abdomen

　　小腹处隐隐作痛并伴有痉挛的感觉。

Pain that radiates to your lower back and thighs

　　痛楚会延伸到下背和大腿处。

Some women also experience:

有的女性会有如下经历：

Nausea and vomiting

Loose stools

　　腹泻

Sweating

　　发汗

Dizziness

　　头晕

When to see a doctor

什么时候应该去看医生

If you've started menstruating within the past few years and are experiencing cramps, chances are your menstrual pain is not a cause for concern. However, if menstrual cramps disrupt your life for several days a month or if you're older and just started experiencing severe menstrual cramps, see your doctor.

   　　 如果你是近几年才开始经痛的话， 也许可以放宽心不必太在意.  但是如果在每个月的那几天经痛会影响到你的生活或是你年纪大了才开始有痛经问题，请去看医生。

Causes

By Mayo Clinic staff

By Mayo Clinic staff

During menstrual periods, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more severe menstrual cramps.

　　月经期间，子宫会收缩帮助子宫内膜脱落。类似荷尔蒙的物质（前列腺素）与疼痛和发炎有关，这会引起子宫收缩。较高的前列腺素常引起较严重的痛经。

Many experts believe that severe contractions constrict the blood vessels feeding the uterus. The resulting pain can be compared to the angina that occurs when blocked coronary arteries starve portions of the heart of food and oxygen.

Menstrual cramps also may be caused by:

痛经还有可能由以下原因引起：

Endometriosis. In this painful condition, the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.

Uterine fibroids. These noncancerous growths in the wall of the uterus rarely may be the cause of pain.

　　子宫平滑肌瘤。这种长在子宫壁上的良性肿瘤可能会造成疼痛。

Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.

　　内在性子宫内膜异位（子宫腺肌病）。子宫内膜向子宫肌层生长。

Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.

　　盆腔炎（PID）。这种女性生殖器官炎症通常是通过性交感染的。

Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.

　　宫颈狭窄。有些女性宫颈口太小以致于经血无法顺利流出，从而使子宫内压增大而导致疼痛。

Risk factors

风险因素

By Mayo Clinic staff

By Mayo Clinic staff

Risk factors associated with dysmenorrhea include:

 痛经有关的风险因素包括：

Age younger than 20

　　年龄小于20岁

Early onset of puberty (age 11 or younger)

 　　青春期发育过早（11岁或更早）

Heavy bleeding during periods (menorrhagia)

　　经血量大（月经过多）

Irregular menstrual bleeding (metrorrhagia)

Never having delivered a baby

Family history of dysmenorrhea

Smoking

Complications

并发症

By Mayo Clinic staff

By Mayo Clinic staff

Menstrual cramps have no medical complications in themselves, but they often interfere with school, work and social activities.

　　痛经本身不会有并发症，但是常常会影响到学习，工作及社交活动。

The diseases and conditions sometimes associated with menstrual cramps may have complications, though. For example, endometriosis can cause fertility problems, while pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting in the tube (ectopic pregnancy) instead of in your uterus.

　　与痛经有关的疾病可能会引起并发症。比如，子宫内膜异位会导致不孕，而盆腔炎可能会阻塞输卵管，增加宫外孕的风险。

Preparing for your appointment

    为咨询医生做准备

By Mayo Clinic staff

By Mayo Clinic staff

While you may initially see your family physician, he or she may refer you to a gynecologist. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

当你咨询你家庭医生时，他可能会建议你去找妇科医生。以下信息可以帮助你为会诊做准备。

What you can do

   你可以做的事？

You may want to write a list that includes:

   列个清单：

Detailed descriptions of your symptoms

The dates when your last two menstrual periods began

　　前2次月经来的时间

Information about medical problems you've had

Information about the medical problems of your parents or siblings

　　你父母或姐妹的病史

All the medications and dietary supplements you take

　　你用过的药物和食物 

Questions you want to ask the doctor

你想要问医生的问题

Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important, in case time runs out. For menstrual cramps, some basic questions to ask your doctor include:

What is likely causing my symptoms?

Are there other possible causes for my symptoms?

　　还有其他可能的原因吗？

How do my symptoms compare with other menstruating girls or women?

　　自己的痛经症状与其他女性相比有什么不一样吗？

Are my symptoms likely to change over time?

Do I need any tests?

　　我需要做检查吗？

What treatments or home remedies might help?

　　治疗或者家庭健康疗法对痛经会有帮助吗？

Are there any brochures or other printed material that I can take with me? What websites do you recommend?

　　是否有手册或其他资料我可以带走的？或者有什么相关网站可以推荐的？

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

除了事先准备的问题外，门诊时有疑问可以随时提出。

What to expect from your doctor

期望可以医生那里得到什么样的信息。

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to go over additional questions you may have. Your doctor may ask:

At what age did you begin menstruating?

　　初潮在什么年龄?

How far apart are your menstrual periods, and how long do they typically last?

How heavy is your menstrual bleeding?

　　经血量多吗？

Do you ever bleed between periods?

　　非月经期间会出血吗？

How would you describe your symptoms?

Where are your cramps located?

Do you have any other symptoms, such as nausea, vomiting, diarrhea, back pain, dizziness or headache?

　　还有其他症状吗，比如说 恶心，呕吐，腹泻，背痛，头晕或头痛的？

Do your symptoms typically occur along with your period?

　　月经期间都会出现这些症状吗？

Do you have any symptoms between periods?

　　非月经期间会有不适吗？

Do your symptoms cause you to limit your activities, such as staying home from work or school or avoiding exercise?

If you're sexually active, do you experience pain with intercourse?

　　性交时会觉得痛吗？

Do you have difficulty or pain with bowel movements?

What treatments have you tried so far, if any? Has anything helped?

　　目前为止，有接受过治疗吗？有帮助吗？

What medications, vitamins and supplements do you use?

　　有使用过什么药物，维生素和其他东西？

Have you been diagnosed with any other medical conditions?

　　有使用医学设备诊断过吗？

Do any of the women in your family have a history of similar symptoms?

　　家族中的其他女性有类似的症状吗？

What you can do in the meantime

痛经期间你能做什么？

In the time leading up to your appointment, you may find relief by taking a warm bath or applying a heating pad or hot water bottle to your abdomen. Over-the-counter pain relievers, such as ibuprofen, also may help.

Tests and diagnosis

By Mayo Clinic staff

By Mayo Clinic staff

Your doctor will review your medical history and perform a physical examination, including a pelvic exam. During the pelvic exam, your doctor will check for any abnormalities in your reproductive organs and look for signs of infection.

医生会确认你的病史然后给你做个身体檢查，包括骨盆檢查。此项檢查，医生会檢查你的生殖器官看看有没有感染的迹象。 

In some cases, if your doctor suspects that your menstrual cramps are being caused by an underlying disorder, he or she may order one or more of the following tests:

在这里输入译文

Ultrasound. This painless test uses sound waves to visualize internal organs. It is often used to check for abnormalities in the uterus, cervix and fallopian tubes.

　　超声波。这是一种无痛检查，利用声波来窥视人体内部器官。常被用来检查子宫，宫颈    处的异常状况。

Computerized tomography (CT). A CT scan combines X-ray images taken from many angles to produce cross-sectional images of bones, organs and other soft tissues inside your body. This painless procedure can provide more detail than can regular X-rays.

　　电子计算机X射线断层扫描技术（CT）。CT是利用X射线可以在人体内多角度扫描来检查骨头，器官还有其他软组织的病变状况。通过这种无痛治疗获得的信息比常规的X射线检查要多。

Magnetic resonance imaging (MRI). MRIs use radio waves and a powerful magnetic field to produce detailed images of internal structures. This painless procedure may be used to check for tumors or signs of endometriosis.

　　核磁共振（MRI）。MRI是利用无线电波和强大的磁场进入人体来获得人体内部组织的详细影像。这种无痛治疗可以用来诊断肿瘤或者子宫内膜异位。

Hysteroscopy. In this procedure, your doctor inserts a thin, lighted tube through your vagina and cervix into your uterus. The hysteroscope works like a tiny telescope, allowing your doctor to look through it to check for such things as fibroids or polyps.

　　子宫镜检查。子宫镜检查是指医生通过阴道和子宫颈插入一根轻薄的管子进入到你的子宫。子宫镜就像是一部微型的望眼镜使医生可以检查到你子宫内的纤维瘤或者息肉等。

Laparoscopy. In this outpatient surgical procedure, your doctor views your abdominal cavity by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens. Laparoscopy can check for certain conditions, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy.

　　腹腔镜检查。腹腔镜检查属于外科门诊，医生会在你的腹部处切一小口，然后插入一根带有摄像头的纤维光学管，以此来检查你的腹腔。这种检查可以确认到子宫内膜异位，粘膜，纤维瘤，卵巢囊肿和宫外孕等症状。

Treatments and drugs

治疗与药物 

By Mayo Clinic staff

By Mayo Clinic staff1

Menstrual cramps are a treatable condition. Your doctor may recommend:

痛经是可治疗的，你的医生可能有如下建议：

NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be helpful in relieving the pain of menstrual cramps. Your doctor may initially suggest taking over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve), at regular doses starting the day before you expect your period to begin. Prescription NSAIDs, such as mefenamic acid (Ponstel), are also available.

　　非甾体类抗炎药（NSAIDs）。NSAIDs 可以缓解经痛症状。首先医生可能会建议你在经期前一天服用些非处方药 NSAIDs，如 布洛芬（解热镇痛药，布洛芬制剂，其他）或者萘普生。处方药 NSAIDs如甲灭酸（甲灭酸制剂的商品名）也可以服用。

Hormonal birth control. Oral birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps. These hormones can also be delivered in several other forms: an injection, a patch you wear on your skin, an implant placed under the skin of your arm or a flexible ring that you insert into your vagina.

　　荷尔蒙控制生育。口服含激素的药片会阻止排卵和降低痛经的严重度。这种荷尔蒙可以以几种方式进入人体，如注射即在皮肤表面割一小口然后从手臂处植入，或者在阴道处插入一个柔软的环状物体。

Surgery. If your menstrual cramps are caused by an underlying disorder, such as endometriosis or fibroids, the surgical removal of the abnormal tissue may help reduce your symptoms.

　　手术。如果痛经是由于身体内部紊乱引起的，比如说纤维瘤或者子宫内膜异位，进行手术切除不良组织可能有助与缓解疼痛症状。 

Lifestyle and home remedies

生活方式与家庭健康疗法 

By Mayo Clinic staff

By Mayo Clinic staff

Soaking in a hot bath or using a heating pad on your lower abdomen appears to be just as effective as over-the-counter pain medication for relieving menstrual cramps.

　　泡热水澡或者热敷小腹可以缓解经痛，这效果与到医院看医生的效果是相当的。 

Alternative medicine

非药物治疗方法

By Mayo Clinic staff

By Mayo Clinic staff

Alternative therapeutic approaches to menstrual cramps include:

痛经的治疗方法包括： 

Exercise. Studies have found that physical activity may ease the pain of menstrual cramps.

　　运动。 研究表明做运动可能会减轻痛经症状。

Acupuncture. Acupuncture has been used in China to relieve pain for more than 2,000 years. Some studies have found that acupuncture effectively relieves menstrual cramps.

　　针灸。2000多年前中国已经使用针灸来缓解疼痛了。有研究表明针灸可以有效的缓解经痛。 1

Transcutaneous electrical nerve stimulation (TENS). A TENS device raises the threshold for pain signals and stimulates the release of endorphins, your body's natural painkillers. In studies, TENS has been found more effective than placebo in relieving the pain associated with menstrual cramps.

　　经皮电刺激神经疗法（TENS）。经皮电刺激神经疗法可以使皮肤很快的感觉到痛和刺激内啡肽的释放，可以舒缓疼痛的讯息。研究表明TENS 安慰剂更能缓解经痛引起的痛楚。

Dietary supplements. A number of studies have indicated that vitamin E, omega-3 fatty acids, vitamin B1 (thiamine), vitamin B-6 and magnesium supplements may effectively reduce menstrual cramps.

　　饮食方面，大量研究表明维生素E，omega-3脂肪酸，维生素 B1，维生素B-6，镁元素可能会有效的缓解经痛。