Первичная дисменорея. Динамика научных взглядов и восприятие женщинами


DOI: https://dx.doi.org/10.18565/pharmateca.2022.6.10-21

Дикке Г.Б.

Академия медицинского образования им. Ф.И. Иноземцева, Санкт-Петербург, Россия
Обоснование. Первичная дисменорея (ПД) широко распространена, но пациенты обращаются за медицинской помощью редко. В последние годы литература пополнилась новыми сведениями о патогенезе и подходах к лечению.
Основные положения. Распространенность ПД широко варьируется в разных регионах мира, составляя от 16 до 91%. Клиническая картина ПД кроме менструальной боли представлена широким диапазоном других симптомов, частота которых индивидуальна. В патогенезе утвердилась теория о ведущей роли простагландинов, нарушении сократительной активности миометрия, его ишемии и воспалительной реакции эндометрия. Патогенетически обоснованным является лечение с помощью нестероидных противовоспалительных средств (НПВС), эффективность которых достигает 70-87,5%, комбинированные оральные контрацептивы рассматриваются в качестве помощи второй линии с эффективностью 62,5-72%. Подтвержден эффект снижения боли от некоторых продуктов питания, физических упражнений, пищевых добавок, лекарственных растений и иглоукалывания, которые рекомендуется использовать в качестве дополнительной терапии.
Выводы. ПД хорошо поддается лечению при использовании современных средств с доказанной эффективностью, а также методов дополнительной и альтернативной терапии. Из группы НПВС напроксен (нексемезин) отличается высокой эффективностью и лучшим профилем безопасности (особенно в отношении сердечно-сосудистой системы).

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Об авторах / Для корреспонденции


Автор для связи: Галина Борисовна Дикке, д.м.н., доцент, профессор кафедры акушерства и гинекологии с курсом репродуктивной медицины, Академия медицинского образования им. Ф.И. Иноземцева, Санкт-Петербург, Россия; galadikke@yandex.ru; ORCID: https://orcid.org/0000-0001- 9524-8962


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