Dysmenorrhoea

Question 1

Defintion

Answer 1

Pain occurring with menstruation. Most women do experience mild period pain, but it can become debilitating.

Question 2

Aetiology

Answer 2

Primary:
- Absence of pathology - idiopathic
Secondary:
- PID
- Endometriosis
- Adenomyosis
- Fibroids
- Uterine polyps

Question 3

Diagnosis

Answer 3

• Rule out differentials
• Bimanual or abdominal examination
• Pelvic US

Question 4

Treatment

Answer 4

• Lifestyle modifications = regular exercise, heat pads
• First Line: oral NSAID e.g. ibuprofen, naproxen +/- paracetamol, mefenamic acid
• Alternate First Line: COCP
• Second Line: NSAID / paracetamol plus COCP (or alternative hormonal contraception