Ch 5.2 - Dysmenorrhoea & Menorrhagia

Question 1

What is primary and secondary dysmenorrhoea?

Answer 1

Primary dysmenorrhoea - Occurs in women 17-25. defined as pain in the absence of pelvic disease

Secondary - pain which may be due to underlying disease. common over 30

Question 2

What is PMS and its symptoms?

Answer 2

Premenstrual syndrome - collection of physical and mental symptoms related to the menstrual cycle.

Bloated, weight gain, headaches
Depression, irritability, tiredness

Question 3

What is thought to be the cause of dysmenorrhoea?

Answer 3

Increased prostaglandin activity

Question 4

When to refer for dysmenorrhoea?

Answer 4

Presence of abnormal vaginal discharge
Abnormal bleeding
Symptoms suggest secondary dysmenorrhoea
Severe intermenstrual pain (mittelschmerz) and bleeding
Failure of medication
Pain with a late period (possibility of an ectopic pregnancy)
Presence of fever

Question 5

Management of dysmenorrhoea

Answer 5

Ibuprofen - prostaglandin inhibitor
Aspirin
Paracetamol - not effective as has no effect on prostaglandin levels - alternative when patient can’t take ibu/aspirin

Question 6

Non - drug treatments for dysmenorrhoea

Answer 6

TENS - painrelief machine
Acupuncture
Locally applied heat
Fish oil

Question 7

what is menorrhagia?

Answer 7

excessive bleeding- interfering with quality of life 60-80ml or more per period

Question 8

When to refer for menorrhagia?

Answer 8

Presence of abnormal vaginal discharge 
Pelvic pain
Pain on intercourse
Dysmenorrhoea
Presence of fever

Question 9

Treatment option for menorrhagia?

Answer 9

Tranexamic acid - reduces volume of menstrual blood by increasing blood clotting