Painful periods (dysmenorrhea): causes and treatment in Tashkent

Other names: Болезненные менструации, альгодисменорея, менструальная боль

Painful menstruation is the most common gynecological complaint and at the same time the one that is most often devalued: “be patient,” “this is normal,” “it will go away after childbirth.” Meanwhile, pain that causes you to miss work or school is not the norm. It can be primary, associated with the characteristics of uterine contractions, or secondary - a symptom of endometriosis, fibroids or another disease.

🧾 МКБ-10: N94.4 🏥 Where it is treated: 3 Severe pain is not normalMay be a symptom of endometriosisTreats well

👨‍⚕️ Which doctor

Gynecologist

🔬 Diagnostics

Examination, ultrasound, laparoscopy if necessary

💊 Treatment

NSAIDs, hormonal therapy, treatment of the cause

📈 Prognosis

good

⚠️ At risk

Endometriosis, fibroids, early menarche

⏱ When to see a doctor

Scheduled appeal

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Боль, из-за которой приходится пропускать работу или учёбу
Боль, не снимающаяся обычными обезболивающими
Боль, появившаяся впервые после 25 лет или усилившаяся со временем
Боль вне менструации и при половом акте
Обильные менструации со сгустками
Боль с температурой и выделениями
Отсутствие беременности при регулярной половой жизни

Primary and secondary dysmenorrhea

Primary - begins a year or two after the first menstruation, is associated with excessive production of prostaglandins, causing strong contractions of the uterus. No structural pathology
Secondary - appears later, usually after 25 years, or intensifies over time; caused by a specific disease

The time of appearance and the nature of the dynamics help to distinguish them. Pain that has been there since youth and does not change is often primary. Pain that appears in adulthood or gets worse year after year requires a search for the cause - and very often it turns out to be endometriosis.

Causes of secondary dysmenorrhea

Endometriosis is the most common cause; typically increases in pain over time
Adenomyosis - accompanied by heavy menstruation
Uterine fibroids, especially submucosal fibroids
Chronic inflammatory diseases of the pelvic organs
Adhesive process
Intrauterine device, especially non-hormonal
Endometrial polyps
Malformations of the uterus with impaired outflow of menstrual blood
Cervical stenosis after cervical surgery
Chronic pelvic pain syndrome

Symptoms

Cramping pain in the lower abdomen that begins shortly before or with the onset of menstruation
Radiation of pain to the lower back and inner thighs
Nausea, sometimes vomiting
Diarrhea or, conversely, constipation
Headache, dizziness
Weakness, sweating
Irritability, decreased mood
In the primary form, the pain is maximum on the first or second day and gradually subsides
In the secondary form, pain may begin several days before menstruation and last longer.

Практический ориентир для оценки: если обезболивающее в обычной дозе полностью снимает боль и вы можете вести привычную жизнь — ситуация управляема. Если приходится увеличивать дозы, лежать весь день или отменять планы, это повод для обследования, а не для терпения.

Survey

Detailed questioning: when did the pain start, how did it change, what helps
Examination by a gynecologist with assessment of painful vaults and uterine mobility
Ultrasound of the pelvic organs - detection of fibroids, adenomyosis, endometrioid cysts, developmental anomalies
Pap smear and infection testing
MRI of the pelvis for suspected deep endometriosis
Hysteroscopy for suspected pathology of the uterine cavity
Diagnostic laparoscopy - for persistent pain and suspicion of endometriosis, when ultrasound does not give an answer
Pain diary - helps to evaluate the dynamics and effectiveness of treatment
Exclusion of other causes of pain: intestinal, urological, muscle

Treatment

Nonsteroidal anti-inflammatory drugs are the mainstay of treatment; they block the production of prostaglandins and are most effective when taken several hours before or at the very beginning of expected pain
Combined hormonal contraceptives, including continuous use
Progesterone preparations
Intrauterine hormonal system - significantly reduces pain and blood loss
Antispasmodics as a supplement
Treatment of the identified cause: endometriosis, fibroids, polyps, inflammation
Laparoscopic removal of endometriosis lesions
Warmth on the lower abdomen, physical activity, regular aerobic exercise
Working with the pelvic floor muscles during spasm
Quitting smoking
Psychological support for chronic pain

A practical note about painkillers: They work best if you take them before the pain becomes severe. Waiting “until it gets really bad” reduces effectiveness because prostaglandins have already been produced.

Why can't you just be patient?

За болью может стоять эндометриоз, при котором время играет против: спайки и повреждение труб накапливаются
Годы терпения — это годы сниженного качества жизни, пропущенной работы и учёбы
Регулярный приём больших доз обезболивающих без наблюдения вредит желудку и почкам
Хроническая боль меняет работу нервной системы, и со временем лечить её становится сложнее
Многие причины прекрасно поддаются лечению — терпение просто не нужно

Отдельно стоит развеять распространённое убеждение: роды не лечат дисменорею. У части женщин боль после родов действительно уменьшается, но рассчитывать на это как на метод лечения и откладывать обследование на годы не стоит — особенно если причиной является эндометриоз.

Where to get examined in Tashkent

You need an examination by a gynecologist, a high-quality ultrasound and, if endometriosis is suspected, access to MRI and laparoscopy.

In Tashkent, such examination and treatment are carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.

If pain during menstruation prevents you from living your normal life, this is a sufficient reason to visit a doctor. There is no need to wait until it becomes “completely unbearable”, and there is no need to prove the seriousness of your pain. Clinic contacts are below.

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичный приём гинекологаfrom 200 000 Диагностическая лапароскопияfrom 6 500 000

💊 Treatment

Блокады в гинекологии: парацервикальная, паралимфатическая, по Школьниковуfrom 140 000 Введение ВМС (со спиралью)from 550 000

Frequently asked questions: Dysmenorrhea (painful menstruation)

What pain during menstruation is considered normal?+

Moderate discomfort on the first or second day, which does not interfere with normal life and is well relieved with the usual dose of pain medication, is considered acceptable. If you have to miss work or school, lie down all day, increase the dosage of medications - this is already a reason for examination, and not an option for the norm.

Is it true that it will go away after giving birth?+

In some women with primary dysmenorrhea, pain after childbirth actually decreases. But you cannot count on this as a treatment, especially if the cause is endometriosis: it will not disappear, and years of waiting will result in adhesions and possible problems with conception. It’s worth getting examined without delay.

Is it harmful to take painkillers all the time?+

Regularly taking large doses of non-steroidal anti-inflammatory drugs without medical supervision can damage the lining of the stomach and kidneys. In addition, the need to constantly take them is in itself a sign that you need to find and treat the cause of the pain, and not just drown it out.

When is the best time to take pain medication?+

It is most effective to take the drug before the pain becomes severe - at its very beginning or even a few hours before the expected appearance. These drugs block the production of prostaglandins, and if they have already been produced, the effect will be weaker. The regimen should be discussed with your doctor.

Could soreness be a sign of endometriosis?+

Yes, and this is one of its most common reasons. Worrying: pain that appeared in adulthood, intensifying from year to year, starting a few days before menstruation, accompanied by pain during sexual intercourse and spotting. With such a picture, an examination is necessary.

Do hormonal contraceptives help?+

Yes, they reduce pain in most women: they reduce the production of prostaglandins, reduce the volume of menstruation, and continuously reduce the number of menstruation itself. However, they do not cure endometriosis completely, but effectively control its manifestations. The doctor selects them.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated dysmenorrhea в Ташкенте

Home задача при болезненных менструациях — не заглушить боль, а понять, нет ли за ней эндометриоза, миомы или другого заболевания. В Ташкенте такое обследование, включая УЗИ и при необходимости диагностическую лапароскопию, проводят в медицинском центре UROLOGIC COMPLEX и в clinicsе Tashkent Medical Park.