dysmenorrhea

Question 1

what is dysmenorrhea ?

Answer 1

painful menstrual cramps of uterine origin

Question 2

what are the types of dysmenorrhea ?

Answer 2

primary and secondary

Question 3

what is primary dysmenorrhea due to ?

Answer 3

during endometrial sloughing there is release of prostaglandins which stimulates uterine contractions as well as ischaemia which causes the pain

Question 4

when can we declare secondary dysmenorrhea ?

Answer 4

1. when a woman experiences dysmenorrhea during the first one or two cycles of menarche
2. first occurence of dysmenorrhea after the age of 25
3. late onset of dysmenorrhea after no history of pain with menstruation

Question 5

if secondary amenorrhea is suspected what is the next best step in management ?

Answer 5

pelvic examination

pelvic ultrasound

Question 6

If the patient is known to be at risk of sexually transmitted diseases what is the next best step in management ?

Answer 6

appropriate swabs should be taken

Question 7

what is the treatment of dysmenorrhea?

Answer 7

aim is to relieve pain so :
Analgesics 
Hormonal treatment to inhibit ovulation
IUD ( releases levonorgestrel which is a type of synthetic progesterone)
danazol (GnRH)

Question 8

what are the non pharmacological treatments for dysmenorrhea ?

Answer 8

dietary changes
physical exercise
TENS , transcutaneous electrical nerve stimulation

Question 9

what effect does danazol have ?

Answer 9

danazol is an androgenic hormone, acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins ( decreases LH and FSH )
causing endometrial atrophy and amenorrhea in some women