Dysmenorrhea is defined as painful menstruation. It is experienced by 45-95% of women of reproductive age. There may not be identifiable pelvic pathology. There is some evidence to support the assertion that dysmenorrhea improves after childbirth and it also appears to decline with increasing age.
Common causes of dysmenorrhea includes endometriosis and adenomyosis; pelvic inflammatory disease; cervical stenosis and rarely haematometra.
Females experiencing dysmenorrhea usually will have different ideas as to what constitutes a painful period. Some may need to take pain killers for the pain and may need to take time of work or school due to the pain.
An abdominal and pelvic examination should be performed. Certain signs associated with endometriosis include a pelvic mass (if an endometrioma is present), a fixed uterus (if adhesions are present) and endometriotic nodules (palpable in the pouch of Douglas or on the uterosacral ligaments).
Investigations to be done include high vaginal and endocervical swabs to exclude pelvic infections such as Chlamydia trachomatis and Neisseria gonorrhea; pelvic ultrasound scan to detect endometriomas or appearance suggestive of adenomyosis (enlarged uterus with heterogenous texture); and a diagnostic laparoscopy.
Management involves the use of Non-steroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, levonorgestrel intrauterine system and Gonadotropin releasing hormoneanalogue. There is some evidence that low fat, vegetarian diet may improve dysmenorrhea. There are suggestions that exercise may improve symptoms by improving blood flow to the pelvis. There is also a strong evidence that heat Is beneficial in the management of dysmenorrhea and appears to be as effective as NSAIDs. Kindly share all our post you find interesting.
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