Menstrual Disorders Flashcards
Dysmenorrhea
Dysmenorrhea refers to cyclical lower abdominal pain associated with menstruation. The pain is thought to result from uterine contractions. It may be primary when there is no identifiable cause or secondary when associated with an underlying cause.
Causes
y Often no underlying cause (primary)
y Uterinefibroids
y Chronic pelvic infections e.g. Chlamydial infections y Endometriosis
Symptoms
y Lower abdominal pain that is cramping or colicky in nature but may be dull and constant
y Pain may radiate to the lower back or legs
y Nausea, vomiting, headaches and dizziness may sometimes be
associated with the pain
Signs
y No typical physical signs
Investigations
y FBC
y Sickling
y Pelvic ultrasound scan to rule out pelvic lesions such as fibroids
Treatment
Treatment objectives
y To relieve pain
y To treat underlying cause
Non-pharmacological treatment
y Bed rest
y Warm pads applied to the lower abdomen
Pharmacological treatment
A. Mild Cases
1st Line Treatment
Evidence Rating: [A]
y Paracetamol, oral, 1 g 6-8 hourly
B� Severe cases
y Ibuprofen, oral, 200-400 mg 8 hourly Or
Referral Criteria
Refer to a gynaecologist if pain interferes with normal activity especially if treatment is ineffective or an underlying cause is identified.
