dysmenorrhoea

Question 1

what is dysmenorrhoea?

Answer 1

excessive pain during the menstrual period

Question 2

what can dysmenorrhoea be divided into?

Answer 2

primary and secondary

Question 3

what is primary dysmenorrhoea?

Answer 3

no underlying pelvic pathology

affects 50% of menstruating women

usually appears within 1-2 years of menarche

excessive endometrial prostaglandin production is thought to be partially responsible

Question 4

what are the features of primary dysmenorrhoea?

Answer 4

• pain starts just before/within a few hrs of period starting
• suprapubic cramping pains, may radiate to back or down thigh

Question 5

how is primary dysmenorrhoea managed?

Answer 5

1st line: NSAIDs e.g. mefenamic acid and ibuprofen (inhibits prostaglandin production)

2nd line: COCP

Question 6

what is secondary dysmenorrhoea?

Answer 6

develops many years after menarche, the result of an underlying pathology

Question 7

what is the feature of secondary dysmenorrhoea?

Answer 7

pain usually starts 3-4 days before onset of period

Question 8

what are the causes of secondary dysmenorrhoea?

Answer 8

• endometriosis
• adenomyosis
• PID
• IUD* (normal copper coils)
• fibroids

*N.B. intrauterine system (Mirena) may help dysmenorrhoea