Menses Flashcards
primary dysmenorrhea is
painful menses (cramping) due to excessive prostaglandin production (inflammation) that interferes with daily activities
fatigue, headache, nausea and abdominal cramping on the onset of menstruation that lasts 2-3 days
primary dysmenorrhea
primary dysmenorrhea diagnosis
diagnosis is based on cyclic pelvic pain (menses) and normal pelvic exam (no fixed uterus and adnexal mass)
primary dysmenorrhea treatment is
NSAIDS or OCPs
if there are persistent symptoms for 3 months with primary dysmenorrhea then
start on dual regimen of NSAIDS and OCPs
If there are persistent symptoms after dual therapy (NSAIDs and OCPs) for primary dysmenorrhea then management should be
look for secondary causes of pain like adenomyosis and endometriosis Need pelvic ultrasound - look for adenomyosis Need diagnostic laproscopy
what to give for primary dysmenorrhea if pt has a contraindication to OCPs
medroxyprogesterone acetate
contraindications to OCPs
migraine with auras, hypertension >35 yrs with tobacco use) certain antiseizure meds?
Side effect of medroxyprogesterone?
weight gain limits use.
Algorithm for primary dysmenorrhea
Endometriosis
uterine glandular tissue is elsewhere causes pain with menstruation.
prevention of menstrual headaches is with:
mefenamic acid 2 days prior to start of menses and up to end of mensturation.
