Dysmenorrhea Flashcards
What is dysmenorrhea?
- Pain during menstruation that interferes with daily activities
What are the 2 types of dysmenorrhea?
Primary
Secondary
What is primary dysmenorrhea?
- there is no underlying pelvic pathology
What is primary dysmenorrhea thought to be caused by?
Excessive secretion of prostaglandin by the uterus
What are the main features of primary dysmenorrhea?
pain typically starts just before or within a few hours of the period starting
suprapubic cramping pains which may radiate to the back or down the thigh
What is the first line management of dysmenorrhea?
NSAID- Ibuprofen or mefenamic acid
What is the function of NSAID’s?
Inhibit prostaglandin production
What can be used second line for primary dysmenorrhea?
Combined oral contraceptive pills
What is secondary dysmenorrhea due to?
It is a result of an underlying pathology
What is the initial management of someone presenting with secondary dysmenorrhea?
-Refer to gynecology for investigation
What are possible causes of secondary dysmenorrhea?
- endometriosis
- adenomyosis
- chronic pelvic inflammatory disease
- intrauterine devices (copper coil)
- fibroids
What investigations can be done for someone presenting with secondary dysmenorrhea?
- ultrasound of pelvic ⇒ Anatomical abnormality
- laparoscopy ⇒ If Endometriosis is suspected
What is the management of secondary dysmenorrhea?
Surgery to treat underlying cause
