-
American Family Physician Aug 2021Dysmenorrhea is common and usually independent of, rather than secondary to, pelvic pathology. Dysmenorrhea occurs in 50% to 90% of adolescent girls and women of... (Review)
Review
Dysmenorrhea is common and usually independent of, rather than secondary to, pelvic pathology. Dysmenorrhea occurs in 50% to 90% of adolescent girls and women of reproductive age and is a leading cause of absenteeism. Secondary dysmenorrhea as a result of endometriosis, pelvic anatomic abnormalities, or infection may present with progressive worsening of pain, abnormal uterine bleeding, vaginal discharge, or dyspareunia. Initial workup should include a menstrual history and pregnancy test for patients who are sexually active. Nonsteroidal anti-inflammatory drugs and hormonal contraceptives are first-line medical options that may be used independently or in combination. Because most progestin or estrogen-progestin combinations are effective, secondary indications, such as contraception, should be considered. Good evidence supports the effectiveness of some nonpharmacologic options, including exercise, transcutaneous electrical nerve stimulation, heat therapy, and self-acupressure. If secondary dysmenorrhea is suspected, nonsteroidal anti-inflammatory drugs or hormonal therapies may be effective, but further workup should include pelvic examination and ultrasonography. Referral to an obstetrician-gynecologist may be warranted for further evaluation and treatment.
Topics: Contraception; Contraceptives, Oral, Hormonal; Dysmenorrhea; Female; Humans; Ultrasonography
PubMed: 34383437
DOI: No ID Found -
Revista Brasileira de Ginecologia E... Aug 2020Primary dysmenorrhea is defined as menstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing... (Review)
Review
Primary dysmenorrhea is defined as menstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of the menstrual cycle. It has major implications for quality of life, such as limitation of daily activities and psychological stress, being one of the main causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, non-pharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments' contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Dysmenorrhea; Female; Humans; Life Style; Pelvic Pain; Quality of Life
PubMed: 32559803
DOI: 10.1055/s-0040-1712131 -
International Journal of Environmental... Feb 2020Dysmenorrhea often significantly reduces the quality of women's life and is still an important public health problem. Despite numerous studies, the pathomechanism of... (Review)
Review
Dysmenorrhea often significantly reduces the quality of women's life and is still an important public health problem. Despite numerous studies, the pathomechanism of dysmenorrhea is not fully understood. Previous research indicates the complexity of biochemical reactions between the endocrine, vascular, and immune systems. Prostaglandins play a major role in the pathomechanism of dysmenorrhea. In contrast, cytokines and other proinflammatory factors in primary dysmenorrhea are less studied. In addition to the applied pharmacotherapy, more and more studies proving the effectiveness of non-pharmacological methods appear. Therefore, the present work contains a review of the latest research concerning factors involved in dysmenorrhea, as well as therapeutic options. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual gynecology, physiotherapy journals and books.
Topics: Biomarkers; Dysmenorrhea; Female; Humans; Inflammation
PubMed: 32069859
DOI: 10.3390/ijerph17041191 -
Journal of Clinical Research in... Feb 2020Most adolescents will experience discomfort during menstruation. Due to normalization of dysmenorrhea, there is delay to diagnosis and treatment. Non-steroidal...
Most adolescents will experience discomfort during menstruation. Due to normalization of dysmenorrhea, there is delay to diagnosis and treatment. Non-steroidal anti-inflammatories are a first line treatment. Adolescents can safely be offered menstrual suppression with combined hormonal contraception, and progestin-only options. When the above are ineffective, gonadotropin releasing hormone agonists with add back treatment can be considered. Transabdominal ultrasound is indicated when first line treatments do not improve symptoms. Endometriosis should be considered in adolescents who experience ongoing pain despite medical treatment. If laparoscopy is performed and endometriosis visualized, it should be treated with either excision or ablation. Women with endometriosis should be counselled on menstrual suppression until fertility is desired. Management of chronic pain requires the involvement of a multi-disciplinary team.
Topics: Adolescent; Chronic Pain; Complementary Therapies; Diagnosis, Differential; Dysmenorrhea; Endometriosis; Female; Humans; Pelvic Pain; Physical Examination
PubMed: 32041388
DOI: 10.4274/jcrpe.galenos.2019.2019.S0217 -
Current Problems in Pediatric and... May 2022Studies show that between 41% and 91.5% of young women, school-aged and university-aged, are affected by dysmenorrhea. Primary dysmenorrhea, which is caused by the...
Studies show that between 41% and 91.5% of young women, school-aged and university-aged, are affected by dysmenorrhea. Primary dysmenorrhea, which is caused by the production of prostaglandins, is defined as cramping pain in the lower abdomen and/or pelvis occurring just before or during menstruation, in the absence of other diseases such as endometriosis, and typically lasting 1-3 days and with a negative physical examination. Secondary dysmenorrhea presents with similar signs and symptoms but is a result of underlying pelvic pathology, for example endometriosis or uterine fibroids. Dysmenorrhea most typically presents as abdominal cramping; however, it can also present with headaches, nausea, vomiting or other generalized symptoms. The diagnosis is mainly clinical, but other tests such as a pelvic examination, a pregnancy test and STI screening may be helpful in ruling out other sources of pain. Although the mainstay of treatment for dysmenorrhea is NSAIDs and hormonal therapy, lifestyle changes and complementary/alternative medicine can also be helpful approaches. Lifestyle changes include aerobic exercise and stretching, while complementary alternative medicine include peppermint, cinnamon, ginger and other herbs and supplements. Finally, endometriosis must be considered as a potential cause for secondary dysmenorrhea and would warrant a prompt referral to gynecology.
Topics: Adolescent; Aged; Child; Complementary Therapies; Dysmenorrhea; Endometriosis; Female; Humans; Physical Examination; Pregnancy
PubMed: 35523674
DOI: 10.1016/j.cppeds.2022.101186 -
Journal of Obstetrics and Gynaecology... Jul 2017This guideline reviews the investigation and treatment of primary dysmenorrhea.
OBJECTIVE
This guideline reviews the investigation and treatment of primary dysmenorrhea.
INTENDED USERS
Health care providers.
TARGET POPULATION
Women and adolescents experiencing menstrual pain for which no underlying cause has been identified.
EVIDENCE
Published clinical trials, population studies, and review articles cited in PubMed or the Cochrane database from January 2005 to March 2016.
VALIDATION METHODS
Seven clinical questions were generated by the authors and reviewed by the SOGC Clinical Practice-Gynaecology Committee. The available literature was searched. Guideline No. 169 was reviewed and rewritten in order to incorporate current evidence. Recommendations addressing the identified clinical questions were formulated and evaluated using the ranking of the Canadian Task Force on Preventive Health Care.
BENEFITS, HARMS, AND COSTS
Primary dysmenorrhea is common and frequently undertreated. Effective therapy is widely available at minimal cost. Treatment has the potential to improve quality of life and to decrease time lost from school or work.
GUIDELINE UPDATE
This guideline is a revision and update of No. 169, December 2005.
SPONSORS
SOGC.
SUMMARY STATEMENTS
RECOMMENDATIONS.
Topics: Canada; Consensus; Dysmenorrhea; Female; Humans; Risk Factors
PubMed: 28625286
DOI: 10.1016/j.jogc.2016.12.023 -
Human Reproduction Update 2015Primary dysmenorrhea, or painful menstruation in the absence of pelvic pathology, is a common, and often debilitating, gynecological condition that affects between 45... (Review)
Review
BACKGROUND
Primary dysmenorrhea, or painful menstruation in the absence of pelvic pathology, is a common, and often debilitating, gynecological condition that affects between 45 and 95% of menstruating women. Despite the high prevalence, dysmenorrhea is often poorly treated, and even disregarded, by health professionals, pain researchers, and the women themselves, who may accept it as a normal part of the menstrual cycle. This review reports on current knowledge, particularly with regards to the impact and consequences of recurrent menstrual pain on pain sensitivity, mood, quality of life and sleep in women with primary dysmenorrhea.
METHODS
Comprehensive literature searches on primary dysmenorrhea were performed using the electronic databases PubMed, Google Scholar and the Cochrane Library. Full-text manuscripts published between the years 1944 and 2015 were reviewed for relevancy and reference lists were cross-checked for additional relevant studies. In combination with the word 'dysmenorrhea' one or more of the following search terms were used to obtain articles published in peer-reviewed journals only: pain, risk factors, etiology, experimental pain, clinical pain, adenomyosis, chronic pain, women, menstrual cycle, hyperalgesia, pain threshold, pain tolerance, pain sensitivity, pain reactivity, pain perception, central sensitization, quality of life, sleep, treatment, non-steroidal anti-inflammatory drugs.
RESULTS
Women with dysmenorrhea, compared with women without dysmenorrhea, have greater sensitivity to experimental pain both within and outside areas of referred menstrual pain. Importantly, the enhanced pain sensitivity is evident even in phases of the menstrual cycle when women are not experiencing menstrual pain, illustrating that long-term differences in pain perception extend outside of the painful menstruation phase. This enhanced pain sensitivity may increase susceptibility to other chronic pain conditions in later life; dysmenorrhea is a risk factor for fibromyalgia. Further, dysmenorrheic pain has an immediate negative impact on quality of life, for up to a few days every month. Women with primary dysmenorrhea have a significantly reduced quality of life, poorer mood and poorer sleep quality during menstruation compared with their pain-free follicular phase, and compared with the menstruation phase of pain-free control women. The prescribed first-line therapy for menstrual pain remains non-steroidal anti-inflammatory drugs, which are effective in relieving daytime and night-time pain.
CONCLUSION
Further study is needed to determine whether effectively blocking dysmenorrheic pain ameliorates risk for the development of chronic pain disorders and to explore whether it is possible to prevent the development-and not just treat-severe dysmenorrheic pain in adolescent girls. In conclusion, we demonstrate the extensive multi-factorial impact of dysmenorrhea and we encourage and direct researchers to necessary future studies.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Central Nervous System Sensitization; Dysmenorrhea; Female; Humans; Menstruation; Pain; Pain Measurement; Pain Perception; Prevalence; Quality of Life; Risk Factors; Sleep
PubMed: 26346058
DOI: 10.1093/humupd/dmv039 -
Obstetrics and Gynecology Apr 2021
Topics: Dysmenorrhea; Female; Humans
PubMed: 33759824
DOI: 10.1097/AOG.0000000000004341 -
Sleep Medicine Clinics Dec 2023This review encompasses the clinical features and relevance to investigate sleep in women with dysmenorrhea. Dysmenorrhea is a prevalent gynecologic dysfunction that... (Review)
Review
This review encompasses the clinical features and relevance to investigate sleep in women with dysmenorrhea. Dysmenorrhea is a prevalent gynecologic dysfunction that affects the social and professional lives of women. It can occur at every menstrual cycle, depending on the cause and psychologic factors. Studies have reported poor sleep and insomnia symptoms in dysmenorrhea condition, which may intensify the dysmenorrhea manifestation and interfere negatively to its treatment. There is an urgent need to identify the main cause of this dysfunction and provide efficient treatments to minimize the detrimental effects of dysmenorrhea in quality of life of these women.
Topics: Female; Humans; Dysmenorrhea; Quality of Life; Sleep; Sleep Initiation and Maintenance Disorders; Menstrual Cycle
PubMed: 38501517
DOI: 10.1016/j.jsmc.2023.06.006 -
Primary Care Sep 1988Dysmenorrhea is one of the most common gynecologic complaints of young women, affecting approximately half of menstruating females. Although most patients have primary... (Review)
Review
Dysmenorrhea is one of the most common gynecologic complaints of young women, affecting approximately half of menstruating females. Although most patients have primary dysmenorrhea, which although creating much discomfort does not lead to significant physical problems, it is very important to rule out secondary dysmenorrhea to prevent problems with health and fertility. Primary dysmenorrhea is seen only in ovulatory cycles, usually developing within 6 to 12 months of menarche and is characterized by lower midabdominal colicky pain that may radiate to the back and upper thighs. The pain of primary dysmenorrhea starts with the onset of menstrual flow or a few hours following onset and may last for a few hours up to 2 days. The pain of secondary dysmenorrhea usually begins several days before the start of menstrual flow and may be present during much of the menstrual cycle. Pain that occurs with the first menses or after the age of 25 or is associated with anovulatory cycles is more likely to be secondary dysmenorrhea. The causes of secondary dysmenorrhea, such as endometriosis, adenomyosis, complications of intrauterine devices, and congenital abnormalities, will often be associated with abnormalities noted on pelvic examination, and whenever dysmenorrheic patients have any abnormalities, further evaluation is necessary.
Topics: Dysmenorrhea; Female; Humans
PubMed: 3054962
DOI: No ID Found