User:It's gonna be awesome/menstrual pain

經痛#診斷
The diagnosis of dysmenorrhea is usually made simply on a medical history of menstrual pain that interferes with daily activities. However, there is no universally accepted gold standard technique for quantifying the severity of menstrual pains.[14]

只要經痛已經干擾到每天的生活就足以做成經痛的診斷. 世界上並無存在公認的診斷標準來判斷經痛的程度. [14]

Yet, there are quantification models, called menstrual symptometrics, that can be used to estimate the severity of menstrual pains as well as correlate them with pain in other parts of the body, menstrual bleeding and degree of interference with daily activities.[14]

不過一個叫做月經症狀量表 (menstrual symptometrics) 可以用來評估經痛的嚴重度和此疼痛與其他身體部位的相關性、月經(量)干擾生活的程度. [14]

Further work-up

進一步探討

Once a diagnosis of dysmenorrhea is made, further workup is required to search for any secondary underlying cause of it, in order to be able to treat it specifically and to avoid the aggravation of a perhaps serious underlying cause.

一旦"經痛"的診斷確立，那麼應該進一步探討是否有任何潛在的病因存在. 這是為了能對症下藥、防止其他可能造成經痛的潛在疾病被忽視然後惡化.

Further work-up includes a specific medical history of symptoms and menstrual cycles and a pelvic exam.[2] Based on results from these, additional exams and tests may be motivated, such as:

Laboratory tests[2]

Gynecologic ultrasonography[2]

Laparoscopy may be required.[2]

要確保經痛的背後沒有其他潛在疾病，醫師得知患者關於經痛的完整病史、月經週期和骨盆檢查. 基於前述三種檢查的結果，醫師可以用Laboratory tests[2]、Gynecologic ultrasonography[2]、Laparoscopy、......來進行進一步地確認. [2]

NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) are effective in relieving the pain of primary dysmenorrhea. They can have side effects of nausea, dyspepsia, peptic ulcer, and diarrhea.

People who are unable to take the more common NSAIDs may be prescribed a COX-2 inhibitor.

不含類固醇的抗發炎藥 (NSAIDs)
不含類固醇的抗發炎藥 能有效緩解primary dysmenorrhea 經痛所產生的疼痛感. 不過這類的藥物可能產生噁心、dyspepsia、peptic ulcer、和腹瀉等副作用. 對於那些無法使用常見的不含類固醇的抗發炎藥的人，則可能改處方為COX-2 inhibitor.

Hormonal birth control 賀爾蒙節育 (避孕藥)
Use of hormonal birth control may improve symptoms of primary dysmenorrhea. 使用避孕藥可能改善第一型經痛的症狀. A 2009 systematic review however found limited evidence that the birth control pill, containing low doses or medium doses of oestrogen, reduces pain associated with dysmenorrhea. In addition, no differences between different birth control pill preparations were found.

Norplant and Depo-provera are also effective, since these methods often induce amenorrhea. The intrauterine system (Mirena IUD) may be useful in reducing symptoms.

Other
A review indicated the effectiveness of transdermal nitroglycerin.

其他
一篇回顧數篇論文的回顧性論文表明transdermal nitroglycerin對於治療經痛是有效的.

Alternative medicine
There is insufficient evidence to recommend the use of any herbal or dietary supplements for treating dysmenorrhea, including, melatonin, vitamin E, fennel, dill, chamomile, cinnamon, damask rose, rhubarb, guava, and uzara. Further research is recommended to follow up on weak evidence of benefit for: fenugreek, ginger, valerian, zataria, zinc sulphate, fish oil, and vitamin B1. A 2016 review found that evidence of safety is insufficient for all dietary supplements.

There is some conflicting evidence in the scientific literature, including:

One review found thiamine and vitamin E to be likely effective. It found the effects of fish oil and vitamin B12 to be unknown.

Reviews found tentative evidence that ginger powder may be effective for primary dysmenorrhea.

Another review found Vitamin B1 to be effective. Magnesium supplementation are a promising possible treatment.

A 2008 review found promising evidence for Chinese herbal medicine for primary dysmenorrhea, but that the evidence was limited by its poor methodological quality.

Procedures
Acupuncture: A 2016 Cochrane review found that the randomized controlled trials (RCTs) of acupuncture treatments for dysmenorrhea are of low quality and concluded that it is unknown if acupuncture or acupressure is effective for treating symptoms of primary dysmenorrhea. There are also concerns of bias in study design and in publication, insufficient reporting (few looked at adverse effects), and that they were inconsistent. There are conflicting reports in the literature, including one review which found that acupressure, topical heat, transcutaneous electrical nerve stimulation, and behavioral interventions are likely effective. It found the effect of acupuncture and magnets to be unknown.

A 2007 systematic review found some scientific evidence that behavioral interventions may be effective, but that the results should be viewed with caution due to poor quality of the data.

Spinal manipulation does not appear to be helpful. Although claims have been made for chiropractic care, under the theory that treating subluxations in the spine may decrease symptoms, a 2006 systematic review found that overall no evidence suggests that spinal manipulation is effective for treatment of primary and secondary dysmenorrhea.