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Dysmenorrhea

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Dysmenorrhea

  1. 1. Menstrual Disorders: Dysmenorrhea Health Services TasTAFE Health Services www.tastafe.tas.edu.au Menstrual Disorders: Dysmenorrhea | Page 1
  2. 2. Dysmenorrhea Dysmenorrhea is a term describing painful menstruation that typically involves cramps caused by uterine contractions. Menstrual Disorders: Dysmenorrhea | Page 2
  3. 3. Dysmenorrhea: Dysmenorrhea is divided into two categories: 1. Primary dysmenorrhea 2. Secondary dysmenorrhea Menstrual Disorders: Dysmenorrhea | Page 3
  4. 4. Dysmenorrhea: The definition Primary dysmenorrhea is:  caused by increased prostaglandin production by the endometrium in an ovulatory cycle which cause contraction of the uterus. Note: The highest level is in the first 2 days of menses. Menstrual Disorders: Dysmenorrhea | Page 4
  5. 5. Dysmenorrhea: The definition Secondary dysmenorrhea is:  painful menstruation due to pelvic or uterine pathology. Menstrual Disorders: Dysmenorrhea | Page 5
  6. 6. Dysmenorrhea: Causes Primary dysmenorrhea causes are: Menstrual Disorders: Dysmenorrhea | Page 6
  7. 7. Dysmenorrhea: Causes Secondary dysmenorrhea causes are:  Endometriosis: ectopic implantation of the endometrial tissue in other parts of the pelvic, it’s the most common cause of dysmenorrhea  Adenomiosis: ingrowth of the endometrium into the uterine musculature.  Fibroids  Pelvic infection  Intrauterine device  Cervical stenosis  Congenital uterine or vaginal abnormalities Menstrual Disorders: Dysmenorrhea | Page 7
  8. 8. Dysmenorrhea: Signs          sharp, intermittent spasm, usually in subrapupic area. pain may radiate to the back of the leg or the lower back systemic symptoms: nausea vomiting diarrhea fatigue fever Headache or dizziness Menstrual Disorders: Dysmenorrhea | Page 8
  9. 9. Dysmenorrhea: Assessment A medical assessments should include:  Patient history  Physical examination Primary Dysmenorrhea • cramping pain with menstruation and the physical examination is completely normal Secondary dysmenorrhea the history discloses cramping pain starting after 25 years old with pelvic abnormality history of infertility heavy menstrual flow irregular cycles little or no response to NSAIDs detailed sexual history to asses for inflammation or scaring bimanual pelvic examination in nonmenstrual phase of the cycle laboratory tests for: CBC to R/O anemia Urine analysis to R/O bladder infection Pregnancy test Cervical culture to exclude STI ESR to detect an inflammatory process Pelvic and vaginal U/S Diagnostic laprascopy or lapratomy Menstrual Disorders: Dysmenorrhea | Page 9
  10. 10. Dysmenorrhea: Treatment To treat primary dysmenorrhea:         pain relief : NSAIDs, cyclooxygenase- 2 inhibitor hormonal contraceptives life style changes: daily ex. limit salty foods wt. loss smoking cessation relaxation techniques Menstrual Disorders: Dysmenorrhea | Page 10
  11. 11. Copyright 2013, State of Tasmania. This resource has been developed by TasTAFE Health Services North. All content in this resource has been produced by TasTAFE personnel and is made available to you for your personal research and study. The content in this resource must not be redistributed or copied in any form. Menstrual Disorders: Dysmenorrhea | Page 11

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