Dysmenorrhoea

Question 1

Define Dysmenorrhoea

Answer 1

Painful periods

Question 1

Define Primary dysmenorrhoea

Answer 1

Painful cramping occurs with no identifiable underlying pelvic pathology
6-12 months post menarche

Question 2

Define Secondary dysmenorrhoea

Answer 2

Painful cramping occurs with an underlying pelvic pathology (endometriosis, adenomyosis, fibroids, endometrial polyps, or pelvic inflammatory disease) or by intrauterine device (IUD) insertion.

Question 3

Dysmenorrhoea Risk Factors

Answer 3

Early menarche
Long menstrual phase
Heavy periods
Smoking
Nuliparity

Question 4

Dysmenorrhoea Sx

Answer 4

• Pelvic pain
• Lower abdo pain
• nausea
• malaise

Question 5

How long does dysmenorrhoea lasts for

Answer 5

48-72 hours around MC

Question 6

Dysmenorrhoea differential Dx

Answer 6

• Endometriosis
• Adenomyosis
• PID
• Adhesions
• IBD
• IBS

Question 7

The one modifiable lifestyle change for dysmenorrhoea

Answer 7

Smoking cessation

Question 8

Dysmenorrhoea 1st line Tx

Answer 8

NSAIDs +/- Paracetamol

Question 9

Dysmenorrhoea 2nd line Tx

Answer 9

• COCP for 3-6 months

Question 10

Other than COCP, what hormonal Tx can also be used in dysmenorrhoea

Answer 10

LNG-IUS (Mirena coil)

Question 11

Dysmenorrhoea non-pharmacological adjunct Tx

Answer 11

Local heat - hot water bottle / heat patch

Question 12

Ix in dysmenorrhoea to rule out underlying pathologies

Answer 12

• STI screening NAAT
• HVS
• Endocervical swab
• TVUS