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Annals of the New York Academy of... 2000Dysmenorrhea presents as painful periods that start two to three years after menarche. The pain usually begins when the bleeding starts and lasts for 48-32 hours. The... (Review)
Review
Dysmenorrhea presents as painful periods that start two to three years after menarche. The pain usually begins when the bleeding starts and lasts for 48-32 hours. The cause of menstrual cramps and associated symptoms in primary dysmenorrhea is related to prostaglandin production. In secondary dysmenorrhea, there is documented pelvic pathology that causes the painful menstrual cramps, and treatment is cause related. Available treatments for primary dysmenorrhea--NSAIDS, oral combined contraceptives, beta-blockers, psychotherapeutic methods, and cervical dilatation--are discussed.
Topics: Dysmenorrhea; Female; Humans
PubMed: 10818411
DOI: 10.1111/j.1749-6632.2000.tb06235.x -
Primary Care Mar 2009Primary dysmenorrhea is commonly a straightforward diagnosis that can be made accurately with an attentive history. In young women who have classic symptoms and no... (Review)
Review
Primary dysmenorrhea is commonly a straightforward diagnosis that can be made accurately with an attentive history. In young women who have classic symptoms and no specific indication, a pelvic examination is often unnecessary in the initial evaluation. The opportunity for primary care practitioners to support women in unearthing the best approach to this chronic recurrent discomfort to minimize adverse life impact is significant and valuable. Identification of patients who are incapacitated by their symptoms or have symptoms that represent underlying pathology is a critical component of a careful history. The wide range of treatments available for primary dysmenorrhea virtually ensures that all females troubled by the symptoms can find relief with safe and inexpensive treatments while limiting negative side effects.
Topics: Dysmenorrhea; Female; Humans; Physicians, Family; Primary Health Care; Risk Factors; Women's Health
PubMed: 19231600
DOI: 10.1016/j.pop.2008.10.004 -
Journal of the American Academy of... Mar 1999Dysmenorrhea is a common complaint that causes considerable disruption in a woman's life. Accurate diagnosis of primary and secondary causes with appropriate therapeutic... (Review)
Review
Dysmenorrhea is a common complaint that causes considerable disruption in a woman's life. Accurate diagnosis of primary and secondary causes with appropriate therapeutic intervention leads to significant improvements in quality of life.
Topics: Diagnosis, Differential; Dysmenorrhea; Endometriosis; Female; Humans; Nurse Practitioners; Nursing Assessment; Pelvic Inflammatory Disease; Risk Factors
PubMed: 10504926
DOI: 10.1111/j.1745-7599.1999.tb00549.x -
Annals of the New York Academy of... 2008Dysmenorrhea is the most common gynecologic complaint among adolescent females. Dysmenorrhea in adolescents is usually primary, and is associated with normal ovulatory... (Review)
Review
Dysmenorrhea is the most common gynecologic complaint among adolescent females. Dysmenorrhea in adolescents is usually primary, and is associated with normal ovulatory cycles and with no pelvic pathology. In approximately 10% of adolescents with severe dysmenorrheic symptoms, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins and leukotrienes play an important role in generating the symptoms of dysmenorrhea. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common pharmacologic treatment for dysmenorrhea. A loading dose of NSAIDs (typically twice the regular dose) should be used as initial treatment for dysmenorrhea in adolescents, followed by a regular dose until symptoms abate. Adolescents with symptoms that do not respond to treatment with NSAIDs for three menstrual periods should be offered hormonal treatment such as combined estrogen/progestin oral contraceptive pills for three menstrual cycles. Adolescents with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The adolescent care provider's role is to explain the pathophysiology of dysmenorrhea to every adolescent female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.
Topics: Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Dysmenorrhea; Estrogens; Female; Humans; Menstrual Cycle; Prevalence; Progesterone Congeners; Risk Factors
PubMed: 18574224
DOI: 10.1196/annals.1429.007 -
Clinical Obstetrics and Gynecology Sep 2020Dysmenorrhea is common in adolescents. Most have primary dysmenorrhea and respond to empiric treatment with nonsteroidal anti-inflammatory drugs and/or hormonal... (Review)
Review
Dysmenorrhea is common in adolescents. Most have primary dysmenorrhea and respond to empiric treatment with nonsteroidal anti-inflammatory drugs and/or hormonal therapies. Infrequently, patients have persistent symptoms requiring further evaluation including a pelvic examination, ultrasonography, and/or diagnostic laparoscopy. The most common cause of secondary dysmenorrhea in adolescents is endometriosis. Endometriosis is an estrogen-dependent, inflammatory condition with no surgical or medical cure. Treatment is individualized and typically includes surgical diagnosis with resection and/or ablation limited to visible lesions followed by hormonal suppressive therapy in an attempt to relieve symptoms, limit disease progression, and protect fertility. Multidisciplinary attention to comorbidities and pain management as well as patient education and support are important.
Topics: Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Contraceptives, Oral, Hormonal; Dysmenorrhea; Endometriosis; Female; Gynecologic Surgical Procedures; Gynecological Examination; Humans; Pain Management; Reproductive Health
PubMed: 32366763
DOI: 10.1097/GRF.0000000000000540 -
Therapeutische Umschau. Revue... Jun 1996Primary dysmenorrhea is very frequent in ovulating women; it can even become a disease. In some cases, but not always, it is preceded by premenstrual tensions. Secondary... (Review)
Review
Primary dysmenorrhea is very frequent in ovulating women; it can even become a disease. In some cases, but not always, it is preceded by premenstrual tensions. Secondary dysmenorrhoea should be clearly differentiated, because it is a symptom of uterine abnormalities or adnexal diseases, whereas primary dysmenorrhoea is an entity in itself. The most frequent cause of secondary dysmenorrhoea is endometriosis. Dysmenorrhea membranacea is a rare event, but should not be forgotten. Primary dysmenorrhea involves the entire organism and the psyche of the suffering woman. The problem is its cyclic repetition and everlasting painful expectation. The pathogenesis is more clarified now but nevertheless not yet completely investigated. There is evidence that under the dominating role of sexual hormones paracrine sequelae are occurring, which result in a local increase of prostaglandins. The most important factor is the rhythmic ischemic reaction due to vasoconstriction in small arteries of the uterine wall, causing excruciating pains at times. The treatment is different whether or not children are immediately desired. Oral contraception and progestogens are useful when given days before the onset of menstruation. If the ovulatory cycle should be maintained, the drugs of choice are non-steroidal antiinflammatory preparations, among them naproxen and ibuprofen the most effective. Since those drugs exert side-effects when administered over a long period of time, alternatives must be available. The most appropriate ones are ASS, magnesium, calcium antagonists or tocolytic agents. Few new approaches to further alternative therapies (neuro-stimulation) could not provide a decrease of the uterine contractility in cases of primary dysmenorrhea.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Contraceptives, Oral; Diagnosis, Differential; Dysmenorrhea; Endometrium; Female; Humans; Microscopy, Electron, Scanning; Treatment Outcome
PubMed: 8767549
DOI: No ID Found -
Endocrine Development 2012Primary dysmenorrhea, which affects from 43 to 91% of adolescent girls, is defined as painful uterine cramps that precede and accompany menses. Primary dysmenorrhea is... (Review)
Review
Primary dysmenorrhea, which affects from 43 to 91% of adolescent girls, is defined as painful uterine cramps that precede and accompany menses. Primary dysmenorrhea is related to an overproduction of uterine prostaglandins which induces myometrium hypercontractility and arterioral vasoconstriction, both involved in painful menstrual cramps. In addition, headache, nausea, asthenia, irritability and school absenteeism are frequently reported and need to be quantified through a clinical score. Despite its relevant impact on adolescent quality of life and availability of efficacious medication such as non-steroidal anti-inflammatory drugs, only 15% of affected adolescents consult a physician for this pain syndrome. Pediatricians and gynecologists should thus be more actively involved in the diagnosis and treatment of adolescent primary dysmenorrhea.
Topics: Adolescent; Age of Onset; Dysmenorrhea; Female; Humans; Models, Biological; Pediatrics; Prevalence
PubMed: 22846528
DOI: 10.1159/000331775 -
American Family Physician Aug 1999Primary dysmenorrhea is defined as cramping pain in the lower abdomen occurring just before or during menstruation, in the absence of other diseases such as... (Review)
Review
Primary dysmenorrhea is defined as cramping pain in the lower abdomen occurring just before or during menstruation, in the absence of other diseases such as endometriosis. Prevalence rates are as high as 90 percent. Initial presentation of primary dysmenorrhea typically occurs in adolescence. It is a common cause of absenteeism and reduced quality of life in women. The problem is often underdiagnosed and undertreated. Women with primary dysmenorrhea have increased production of endometrial prostaglandin, resulting in increased uterine tone and stronger, more frequent uterine contractions. A diagnostic evaluation is unnecessary in patients with typical symptoms and no risk factors for secondary causes. Nonsteroidal anti-inflammatory medications are the mainstay of treatment, with the addition of oral contraceptive pills when necessary. About 10 percent of affected women do not respond to these measures. It is important to consider secondary causes of dysmenorrhea in women who do not respond to initial treatment. Many alternative treatments (ranging from acupuncture to laparoscopic surgery) have been studied, but the supporting studies are small, with limited long-term follow-up.
Topics: Algorithms; Dysmenorrhea; Female; Humans
PubMed: 10465224
DOI: No ID Found -
Scientific Reports Nov 2018Primary dysmenorrhea, which is menstrual pain without pelvic pathology, is the most common gynecologic condition in women. Heat therapy has been used as a treatment. We... (Meta-Analysis)
Meta-Analysis
Primary dysmenorrhea, which is menstrual pain without pelvic pathology, is the most common gynecologic condition in women. Heat therapy has been used as a treatment. We assessed the evidence on heat therapy as a treatment for primary dysmenorrhea. We searched 11 databases for studies published through July 2018. All randomized controlled trials (RCTs) that addressed heat therapy for patients with primary dysmenorrhea were included. Data extraction and risk-of-bias assessments were performed by two independent reviewers. Risk of bias was assessed using the Cochrane risk-of-bias tool. Six RCTs met our inclusion criteria. Two RCTs found favorable effects of heat therapy on menstrual pain compared with unheated placebo therapy. Three RCTs found favorable effects of heating pads on menstrual pain compared with analgesic medication (n = 274; SMD -0.72; 95% confidence interval -0.97 to -0.48; P < 0.001; two studies). One RCT showed beneficial effects of heat therapy on menstrual pain compared with no treatment (n = 132; MD -4.04 VAS; 95% CI -4.88 to -3.20; P < 0.001). However, these results are based on relatively few trials with small sample sizes. Our review provided suggestive evidence of the effectiveness of heat therapy for primary dysmenorrhea, but rigorous high-quality trials are still needed to provide robust evidence.
Topics: Dysmenorrhea; Female; Humans; Hyperthermia, Induced; Pain Management; Quality of Life; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 30389956
DOI: 10.1038/s41598-018-34303-z -
Comprehensive Therapy Jun 1982
Review
Topics: Anti-Inflammatory Agents, Non-Steroidal; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Cyclooxygenase Inhibitors; Diagnosis, Differential; Drug Therapy, Combination; Dysmenorrhea; Endometriosis; Female; Humans; Prostaglandins
PubMed: 6809407
DOI: No ID Found