生理痛


機能性月経困難症(原発性月経困難症)

機能性月経困難症とは原発性月経困難症とも言い、病的な異常が発見されない生理痛のことを言います。
排卵が起こると卵巣から2種類のホルモン(卵胞ホルモン(エス..トロゲン)と黄体ホルモン(プロゲステロン))が分泌されます。
これらが子宮内膜に作用して受精卵が着床するためのベッドとなるよう内膜の状態を変化させていくのですが、このとき黄体ホルモンの働きによって子宮内膜の中にプロスタグランディン(Pg)という局所ホルモンが増加します。
このPgが子宮内膜を収縮させて腹痛や腰痛、悪心や頭痛などの症状を引き起こします。
生理痛は、ひどくても我慢してやり過ごしてしまう人がまだまだ多い現状ですが、治療を受けることで、症状は改善されます。

器質性月経困難症(続発性月経困難症)

器質性月経困難症とは続発性月経困難症とも言い、子宮内膜症や子宮筋腫など何らかの原因があって痛みが起こるものを言います。
徐々に月経痛がひどくなったり、月経量が増えてくるのが特徴で、そのような症状に気がついている場合は、子宮筋腫や子宮内膜症がないかの診察を受けた方がよいでしょう。
子宮筋腫はその大きさや場所によって症状がさまざまです。
子宮内膜症は放置しておくと病変部が広がり、将来的に不妊症などになってしまう場合もありますので、経過観察で良いのか、積極的な治療が必要なのかを診察を受けて診断してもらいましょう。
子宮筋腫も子宮内膜症も年々増加傾向しており、近年では、20代の前半から見られるようになってきています。

生理痛症状別チェック

生理痛の症状の中で、次の症状がある場合は、特に注意が必要です。
□生理痛が異常に激しい(鎮痛薬が効かないほど)
□生理以外の日でも、生理痛のような痛みがある
□生理がくるたびに痛みがひどくなる
□経血量が異常に多い
□生理の期間が長引く(10日以上)
□経血に血の固まりが混じる
□吐き気がある
□性交痛がある
上記の症状がある場合は、人科か産婦人科で診察を受けましょう。
なぜ上記のような症状に気をつけなければいけないのかと言うと、子宮の形や位置が異常な場合を除き、主な原因に「子宮内膜症」と「子宮筋腫」が考えられるからです。

心理的・血流が悪い原因

月経痛に痛み止めといって偽の薬を出すと、で3〜4割の人が痛みが軽くなったという実験があります。
月経痛にはもともと、「痛むもの」「嫌なもの」という心理的な影響があると考えられます。
また、ストレスや過労、不規則な生活やバランスのとれていない食生活も自律神経の失調状態を起こし、痛みをひどくすると考えられています。
何か楽しいことや気持ちのよいことを月経の時に計画するのも新しい試みかもしれません。
冷房や薄着などによる冷えは、血流を悪化させ、生理痛をもひどくさせますすので、適度に身体を動かしたり、冷暖房対策も心がけましょう。

腰痛の原因

生理時の腰痛は、生理中妊娠ができる状態にするために子宮が大きくなり腰を圧迫するために起こるもので、ごく自然なことです。
腰痛の痛みの重さに個人差があるのは、骨盤が小さいか大きいかということに隠されています。
あまり痛みがひどいようであれば、股関節や骨盤を柔軟にすると改善されます。
指圧やカイロプラクティックも一つの方法ですね。
また、あまりひどい痛みの場合、子宮筋腫などの疑いも考えられるので、一度病院で検査をする必要があります。
その他、子宮の病気以外の場合も考えられるので、まずは自分の身体のことを良く知ること必要もあります。

生理痛が起こるメカニズム

プロスタグランジンという子宮を収縮させるホルモンが子宮内膜に多い場合、子宮の収縮が強くなり痛みが起こるのが生理痛のメカニズムになります。
その他、子宮口が狭いために経血がスムーズに出て行かないので、それを押し出そうとするために子宮の筋肉が強く収縮するとも言われています。
こういった症状は、出産経験のない女性に多いようです。
強い月経痛が毎回起こる場合には、子宮内膜症や腺筋症、子宮筋腫、薄着や冷房による冷えなどが原因で、骨盤内がうっ血して起こる場合、ストレスで視床下部が正常に働かないなどが考えられます。

子宮口が狭い

子宮の出口(子宮頸管)はもともと構造的に狭くなっています。
子宮が未成熟の10代〜20代前半の方や、出産経験の無い方は、この頚部が狭くて硬いために、月経血が上手く流れずに痛む場合があります。
『出産すると生理痛が軽くなるなどという話がありますが、コレは構造的にも事実です。
一度でも出産を経験することで、頚管が一度広がるのでそれ以降の月経が楽に流れます。
また、10代のころのひどい月経痛は、子宮が成熟してくるとだんだん軽くなることが多いので、様子を見てもいいかもしれません。


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