Period pain (dysmenorrhoea

Question 1

Referral

Answer 1

• Secondary dysmenorrhoea
• Pain inc onset of menses
• > 30 years w new or worsening symptoms
• Vag bleeding post menopause
• Take oral contraceptives
• Fever

Question 2

Treatment: first line (NSAIDs)

Answer 2

Ibuprofen 12+

Naproxen (feminax ultra)
- 15-50 years
- 500mg (2 tabs) initially + one further tab (250mg) 8-8 hours later if needed
- Max 3 tabs each day, max 3 days in a month

• Swallow whole w water after food
• Caution: asthma
• CI: GI events, anticoagulants, pregnancy

Question 3

Treatment: others

Answer 3

Antimuscarinic:
hyoscine hydrobromide 6+ (buscopan)

Anti-spasmodic:
Alverine 12+

Question 4

Advice

Answer 4

Hot water bottle

Exercise

Acupuncture

Fish oil, vit B + E and magnesium