Dysmenorrhoea

Question 1

What is it?

Answer 1

Excessive pain

Question 2

What is primary dysmenorrhoea?

Answer 2

No underlying pelvic pathology normally seen in young women
Usually appears 6 months - 1 year of menarche
Crampy abdominal pain that starts 1-2 days before period

Question 3

What is the management of primary dysmenorrhoea?

Answer 3

NSAIDs such as mefenamic acid and ibuprofen
COCP 2nd line

Question 4

What is secondary dysmenorrhoea?

Answer 4

Dysmenorrhoea due to underlying pelvic pathology such as endometriosis, PID, fibroids

Painful periods- previously not painful
Irregular pain history
Other gynae symptoms e.g. menorrhagia, vaginal discharge
Symptoms start 3-4 days before period start

Question 5

What is the management of secondary dysmenorrhoea?

Answer 5

Refer to gynae for investigation

Question 6

What investigations can be done for dysmenrrhoea?

Answer 6

Pelvic US
High vaginal swab
Pregnancy Test