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The Nurse Practitioner Nov 2014Primary dysmenorrhea is the most common gynecologic complaint among adolescents. Conventional treatments include nonsteroidal anti-inflammatory drugs and hormonal... (Review)
Review
Primary dysmenorrhea is the most common gynecologic complaint among adolescents. Conventional treatments include nonsteroidal anti-inflammatory drugs and hormonal contraceptives, but complementary and alternative medicine is a growing area of interest. As patients seek such treatments, pediatric nurse practitioners should be aware of these options to offer the best advice to patients.
Topics: Adolescent; Complementary Therapies; Dysmenorrhea; Female; Humans; Pediatric Nurse Practitioners; Risk Factors
PubMed: 25325520
DOI: 10.1097/01.NPR.0000454984.19413.28 -
Lijecnicki Vjesnik 2009Dysmenorrhea (painful menstruation), which can be primary or secondary, is a common gynecological problem. Primary dysmenorrhea (normal gynecological finding) is caused... (Review)
Review
Dysmenorrhea (painful menstruation), which can be primary or secondary, is a common gynecological problem. Primary dysmenorrhea (normal gynecological finding) is caused by increased production of uterine prostaglandins. Namely, under the influence of hormonal changes and vegetative factors at the end of a menstrual cycle, in numerous girls and women with a normal gynecological finding, vasoconstriction in small uterine arteries and endometrial ischemia occur, resulting in excessive prostaglandins synthesis in endometrial cells. Local effect of prostaglandins on the uterus is manifested by painful uterine contractions during menstruation. Prostaglandins can cause general symptoms too (headache, nausea, vomiting, diarrhea, urinary frequency) because they are released from endometrial cells and they reach the systemic circulation (increased plasma levels of prostaglandins, particularly F2 alpha prostaglandin). Nonsteroidal anti-inflammatory drugs are established as initial therapy for women with primary dysmenorrhea; besides that, oral contraceptives and other prescription drugs are taken into consideration as well as different forms of complementary therapy. In 20-25% of cases, the reduction of pain is not achieved by use of standard therapy. Clinical experiences have shown that significant pain regression during a menstrual cycle has been often achieved by the use of spinal manipulative therapy (SMT) indicated in women with primary dysmenorrhea with coexisting functional disorders of lumbosacral (LS) spine. Namely, by activation of the nociceptive and vegetative system, LS spine disorders, before all segmental dysfunction and degenerative changes, can induce referred pain and reflex disturbances of pelvic organs (somatovisceral reflexes). Since significant improvement or disappearance of pain during a menstrual cycle is often achieved with adequate therapy of coexisting vertebral disorders in women with primary dysmenorrhea, it is important to recognise latent or manifest vertebral disorders in dysmenorrheic women using clinical examination.
Topics: Dysmenorrhea; Female; Humans; Lumbar Vertebrae; Sacrum; Spinal Diseases
PubMed: 20030292
DOI: No ID Found -
Frontiers in Endocrinology 2024Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether...
BACKGROUND
Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether these associations are causal. This study is to investigate whether menstrual disorders and dysmenorrhea causally affect the risk of CVD.
METHODS
The summary data for menstrual disorders (excessive menstruation and irregular menses) and dysmenorrhea were obtained from FinnGen study, summary data for CVD were obtained from UK Biobank and meta-analysis. The inverse-variance-weighted method was mainly used in the Mendelian randomization for causality analysis. Sensitivity analyses were performed by several methods under different model assumptions.
RESULTS
Genetic liability to excessive menstruation was associated with higher risk of atrial fibrillation (odds ratio (OR), 1.078 [95% confidence interval (CI), 1.015-1.145]; =0.014), but a lower risk of hypertension (OR, 0.994 [95% CI: 0.989-0.999]; =0.016). Irregular menses was associated with higher risk of atrial fibrillation (OR, 1.095 [95% CI: 1.015-1.182]; =0.02), hypertension (OR, 1.007 [95% CI: 1.000-1.013]; =0.047), myocardial infarction (OR, 1.172 [95% CI: 1.060-1.295]; =0.02), ischemic heart disease, (OR, 1.005 [95% CI: 1.000-1.010]; =0.037) and coronary heart disease (OR, 1.004 [95% CI: 1.001-1.008]; =0.026). Dysmenorrhea was associated with higher risk of atrial fibrillation (OR, 1.052 [95% CI: 1.014-1.092]; =0.008) and Ischemic stroke (cardioembolic) (OR, 1.122 [95% CI: 1.002-1.257]; =0.046). After Benjamini-Hochberg correction, irregular menses was associated with higher risk of myocardial infarction.
CONCLUSION
We confirmed a causal relationship of excessive menstruation, irregular menses and dysmenorrhea on cardiovascular outcomes independent of sex hormone levels, with an emphasis on the link between irregular menses and myocardial infarction. These clinical features can be utilized as markers to identify women at higher risk of developing CVD in the future, recommending early clinical intervention of menstrual diseases.
Topics: Female; Humans; Atrial Fibrillation; Cardiovascular Diseases; Dysmenorrhea; Hypertension; Mendelian Randomization Analysis; Menstruation Disturbances; Myocardial Infarction
PubMed: 38375191
DOI: 10.3389/fendo.2024.1302312 -
Southern Medical Journal Oct 1978Organic, physiologic, and psychologic causes of dysmenorrhea are presented. Signs and symptoms include pelvic fullness, nausea, vomiting, diarrhea, urinary frequency,... (Review)
Review
Organic, physiologic, and psychologic causes of dysmenorrhea are presented. Signs and symptoms include pelvic fullness, nausea, vomiting, diarrhea, urinary frequency, nervousness, and headaches. Primary dysmenorrhea has been treated with analgesics, diuretics, and antispasmodics. Androgen therapy was also found to be effective, but it cannot be used for women who have acne or hirsutism. Surgery is rarely indicated for primary dysmenorrhea.
Topics: Dysmenorrhea; Female; Humans; Prostaglandins F
PubMed: 360402
DOI: 10.1097/00007611-197810000-00017 -
Cleveland Clinic Quarterly 1983
Topics: Dysmenorrhea; Endometriosis; Female; Humans; Prostaglandins F
PubMed: 6652903
DOI: 10.3949/ccjm.50.3.367 -
The American Journal of Case Reports Dec 2023BACKGROUND In the 18th century, Morgagni described membranous dysmenorrhea as the sudden and complete detachment of the decidua during menstruation. This causes intense...
BACKGROUND In the 18th century, Morgagni described membranous dysmenorrhea as the sudden and complete detachment of the decidua during menstruation. This causes intense and painful contractions of the myometrium, aggravated by the expulsion of tissues produced by the decidualization of the endometrium. It is a rare pathology associated with oral contraceptives, ectopic pregnancies, abortions, and natural cycles, with consequent thickening and endometrial decidualization with molding of the tissue of the uterine cavity of membranous appearance. The definitive diagnosis is made by histopathological examination. CASE REPORT A 43-year-old female patient came for urgent consultation for an acute picture of severe pain in the lower abdomen, radiating to the genital area with transvaginal bleeding of 2 h of evolution. She had no significant past medical history. A transvaginal ultrasound was performed and showed an unchanged endometrial cavity. A vaginal examination revealed a foreign body of soft consistency; therefore, a speculum examination was performed, which showed tissue of endometrial origin located in the cervical canal of a reddish spongy texture. The tissue was removed, thus improving the symptomatology, and was sent to the pathological anatomy service for histopathologic diagnosis. CONCLUSIONS Membranous dysmenorrhea is a rare gynecologic disorder with only a few documented cases. According to other case reports, our patient's case, at age 43 years, was an atypical presentation. The clinical features and association with this pathology allowed the diagnosis and its confirmation by histopathological examination.
Topics: Adult; Female; Humans; Contraceptives, Oral; Dysmenorrhea; Endometrium; Ultrasonography; Uterus
PubMed: 38111179
DOI: 10.12659/AJCR.941946 -
Schweizerische Rundschau Fur Medizin... Nov 1991
Topics: Dysmenorrhea; Female; Humans
PubMed: 1947559
DOI: No ID Found -
South African Medical Journal =... Aug 1980
Topics: Dysmenorrhea; Female; Humans
PubMed: 7404214
DOI: No ID Found -
African Health Sciences Dec 2019Menstrual pain is one of the common gynaecological presentations of women of reproductive age to health care physicians. In Ghana, there exist a paucity of research on...
BACKGROUND
Menstrual pain is one of the common gynaecological presentations of women of reproductive age to health care physicians. In Ghana, there exist a paucity of research on the risk factors of dysmenorrhea among older females.
OBJECTIVES
Very few studies in Ghana have addressed the risk factors for severe dysmenorrhea among University students. This study aims to identify the common risk factors and associated symptoms of menstrual pain which have been previously not caught the attention of researchers in Ghana.
METHODOLOGY
The study was a descriptive cross-sectional study involving to two hundred female undergraduate students of the University of Cape Coast (UCC), Ghana. Data collected and analysed using standardized and acceptable statistical tools. Verbal multidimensional scoring system for assessment of dysmenorrhoea severity was used in this study to assess the severity of dysmenorrhoea.
RESULTS
More than half (57.3%) of the respondents having pain beginning within the first two days of their menses. The common risk factors that predicted severity of dysmenorrhea (p<0.05) were quantity of menstrual flow and family history of menstrual pain. The common symptoms that accompanied dysmenorrhea were tiredness, loss of appetite, backache, dizziness, diarrhoea and mood changes (p<0.05).
CONCLUSION
Dysmenorrhea is a serious public health problem which can be incapacitating. We advocate for more attention to reduce the burden of its negative consequences.
Topics: Adult; Cross-Sectional Studies; Dysmenorrhea; Female; Ghana; Health Status; Humans; Risk Factors; Socioeconomic Factors; Students; Young Adult
PubMed: 32127874
DOI: 10.4314/ahs.v19i4.20 -
Fertility and Sterility Mar 2023To diagnose endometriosis in young patients ≤25y with severe dysmenorrhea through specific ultrasonographic examination findings and to correlate the symptoms to its... (Observational Study)
Observational Study
OBJECTIVES
To diagnose endometriosis in young patients ≤25y with severe dysmenorrhea through specific ultrasonographic examination findings and to correlate the symptoms to its different forms: ovarian, deep infiltrating endometriosis, and adenomyosis.
DESIGN
A retrospective observational study.
SETTING
University Hospital.
PATIENT(S)
Women aged 12-25 years with severe dysmenorrhea and a visual analog scale score ≥7.
INTERVENTION(S)
This study included 371 women aged 12-25 years referred to our gynecological ultrasound (US) Unit between January 2016 and December 2021 with severe dysmenorrhea and a visual analog scale score ≥7. Two dimensional, 3 dimensional, and power Doppler US pelvic examinations (transvaginal or transrectal in presexually active girls) were performed on all patients. Medical history and symptoms were collected routinely for each patient before the scan.
MAIN OUTCOME MEASURE(S)
All possible locations of endometriosis, isolated or combined occurrence, were evaluated, and recorded using an US dedicated mapping sheet. Painful symptoms were evaluated by visual analog scale and correlated to the different endometriosis forms.
RESULT(S)
At least one US endometriosis feature was identified in 131 (35.3%) patients, whereas the US findings of 170 (45.8%) were normal despite the referred dysmenorrhea. Of the 131 patients with endometriosis, ovarian endometrioma was found in 54 (41.2%), and 22 (16.8%) had an isolated endometrioma. Adenomyosis was detected in 67 (51.1%) patients, and 28 (21.4%) showed its isolated indications. Posterior deep infiltrating endometriosis was found in 70 (53.4%) patients, and uterosacral ligament (USL) fibrotic thickening was found in 63 (48.1%). In 23 patients, the USL lesion was completely isolated. The combined occurrence of dysmenorrhea with dyspareunia, bowel symptoms, and heavy menstrual bleeding increases the presence of endometriosis up to 59%, 63%, and 45%, respectively.
CONCLUSION(S)
In young patients with severe dysmenorrhea, the US-based detection rate of pelvic endometriosis was one-third. USL fibrotic thickening and mild adenomyosis are often the only findings, so an accurate pelvic US scan can provide an early diagnosis by identifying small endometriotic lesions. Young patients with dysmenorrhea should be referred to an expert sonographer to minimize the delay between the onset of symptoms and diagnosis.
Topics: Female; Humans; Dysmenorrhea; Endometriosis; Adenomyosis; Ultrasonography; Ovary
PubMed: 36493871
DOI: 10.1016/j.fertnstert.2022.12.004