[严重的经期障碍和子宫内膜异位症]
Éric Bautrant1, Chloé Lacoste2, Delphine Lhuillery3
1Chirurgien gynécologue et de la douleur, centre L'Avancée, clinique Axium, Aix-en-Provence, et centre de la douleur, hôpital Saint-Joseph, Paris, France.
La Revue du praticien
|June 23, 2025
概括
严重的缺经症是子宫内膜异位症的前体,涉及中央过敏和慢性骨盆疼痛. 有效的管理侧重于多模式治疗,以控制疼痛和预防疾病的进展.
科学领域:
- 妇科 妇科 妇科 妇科
- 疼痛医学 医学 疼痛医学
- 神经学 神经学
背景情况:
- 严重的经期障碍 (3级) 在从初潮开始的子宫内膜异位症患者中很普遍.
- 患有严重经期不良的年轻女孩经常表现出中心过敏,导致慢性盆腔疼痛和并发症.
- 严重的缺经症被认为是子宫内膜异位症的潜在前体.
研究的目的:
- 探索严重的经期障碍和子宫内膜异位症之间的联系.
- 讨论中心过敏性在与子宫内膜异位症相关的盆腔疼痛中的作用.
- 概述严重的缺经症和子宫内膜异位症相关的疼痛的多式治疗策略.
主要方法:
- 文献综述和现有关于失经症,子宫内膜异位症和疼痛管理的研究的综合.
- 在这种背景下,分析中心过敏和神经病痛的病理生理学.
- 讨论各种治疗方式,包括激素治疗,止痛药,抗抑郁药,抗药,物理治疗,TENS,CBT和手术选择.
主要成果:
- 严重的缺经症与中心过敏症密切相关,这是慢性骨盆疼痛的关键因素.
- 虽然子宫内膜异位症病变可以加剧疼痛,但神经病痛通常与中央敏感化有关,而不是直接压缩神经.
- 激素治疗诱导异常,可以抑制感觉的涌入,并防止中央过敏症的恶化.
结论:
- 控制严重的原发性经期障碍对于治疗盆腔疼痛和预防子宫内膜异位症至关重要.
- 多模式治疗,包括激素治疗,止痛药和向中央敏感药物是必不可少的.
- 物理治疗,TENS和认知行为疗法是推的第一线治疗,在特定情况下考虑手术和其他干预措施.
更多相关视频
07:20Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
Published on: December 21, 2012
16.0K
05:36Herbs-Partitioned Moxibustion on the Navel in a Rat Model of Primary Dysmenorrhea with Cold Coagulation and Blood Stasis
Published on: October 4, 2024
645
相关概念视频
01:24Disorders of the Female Reproductive System
510
The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
510
01:18Menses Phase
460
The uterine cycle begins with the menstrual phase, which is considered day one of the cycle and typically lasts about five days. This phase is characterized by the degeneration and shedding of the stratum functionalis, the functional layer of the endometrium.
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...
460
02:07Oogenesis
64.5K
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
64.5K
01:22Hormonal Regulation of the Menstrual Cycle
725
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
725
01:17Drugs for Treatment of Diarrhea-Predominant IBS
313
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
313
01:19The Menstrual Cycle
1.4K
The menstrual cycle is a recurrent sequence of changes in the uterine endometrium, specifically its functional layer, the stratum functionalis. This cycle prepares the uterus for potential pregnancy. This cycle typically spans 21–35 days, averaging 28 days, and aligns with the ovarian cycle, regulated by fluctuating levels of ovarian hormones, primarily estrogen and progesterone.
The menstrual phase occurs from days 1 to 5 and involves the shedding of the stratum functionalis, as a...
The menstrual phase occurs from days 1 to 5 and involves the shedding of the stratum functionalis, as a...
1.4K