月経随伴症状に対する心身医学的対応(<特集>女性をめぐる心身医学)  [in Japanese] Psychosomatic Approach to the Menstruation-related Symptoms(<Special Issue>Clinical Management in Female Psychosomatic Disorders)  [in Japanese]

月経随伴症状の代表的なものとして月経困難症と月経前症候群を取り上げ,一般的事項と心身医学的対応について概説した.月経困難症では,一般的な対処方法についての正しい情報を提供し,同時に月経を主体的にとらえる姿勢を養うことが重要である.器質的疾患がある場合には,それが患者のライフサイクルに与える影響をも視野に入れて対応する.また性的外傷体験をもっているような場合には,特に受容的態度が必要である.月経前症候群では,まず前向的な症状調査で正しく診断することが重要である.そのうえで,この症候群がbiopsychosocialなものであることを認識し,薬物療法と同時に患者の思考や行動パターンにもアプローチしていく.

Dysmenorrhea and premenstrual syndrome are reviewed from the gynecological and psychosomatic point of view. Concerning dysmenorrhea, appropriate information about self-medication of menstrual pain is important and patients should be encouraged to become responsible for their own menstrual experience through the psychosomatic approach. In the patients whose pain is coming from organic diseases including endometriosis, fibroma, and any other conditions, the effects of these conditions on their lifecycle should be considered. If a sexual traumatic experience is present, a supportive approach with particular consideration is necessary. As for premenstrual syndrome, making correct diagnosis with prospective dairy rating is the first priority. Moreover, on the premise that this syndrome is a biopsychosocial condition, the treatment should include not only medical treatment but also intervention in psychological and behavioral problems.