dysmenorhea pain cramp on menstrual day

1. Menstrual Cramp
Ryan saktika Mulyana

2. “Dysmenorrhea” is derived
from a Greek root translating
to Difficult menstrual flow.

3. Primary dysmenorrhea Secondary dysmenorrhea
recurrent, crampy pain
occurring with menses
in the absence of
identifiable pelvic
pathology
menstrual pain
associated with
underlying pelvic
pathology such as
endometriosis.
Dysmenorrhea

4. Primary dysmenorrhea
Begins in adolescence

5. Primary dysmenorrhea

6. excessive levels
of prostaglandins
Causes

7. Worsening factors
• Factors that may make the pain of primary
dysmenorrhea even worse include a uterus that
tilts backward (retroverted uterus) instead of
forward; longer, heavier, or irregular menstrual
periods; lack of exercise; psychological or social
stress; smoking; drinking alcohol; being
overweight; a family history of dysmenorrhea;
and starting menstruating before age 12

8. RISK FACTORS
• Dysmenorrhea is the most common
gynaecological symptom reported by women.
• Ninety percent of women presenting for
primary care suffer from some menstrual pain

9. DIAGNOSIS OF PRIMARY DYSMENORRHEA
Typically, primary
dysmenorrhea is characterized
by a crampy suprapubic pain
Symptoms peak with
maximum blood flow and
usually last less than one
day, but the pain may persist
up to 2 to 3 days
that begins somewhere between
several hours before and a few
hours after the onset of the
menstrual bleeding.

10. but may also be described as dull
and may extend to both lower
quadrants, the lumbar area, and
the thighs.
The pain is characteristically colicky
and located in the midline of the
lower abdomen

15. Hormone-based treatments
Hormonal treatments, specifically oral
contractive pills (OCPs), are widely used
for NSAID-resistant
comparison of 20 mg ethinyl estradiol/ 150 mg
desogestrel to 20 mg ethinyl estradiol/100 mg
levonorgestrel suggested each improved
dysmenorrhea similarly
(23% and 26% of women, respectively).

16. Antispasmodics
Hyoscine butylbromide
is an anticholinergic drug that targets
muscarinic receptors to relax smooth muscle.

17. Hyoscine-N-
Butylbromide (HBB) is a
derivative of hyoscine
which is extracted from
the leaves of the
Duboisia tree found
mainly in Australia.

18. Hyoscine-N-butylbromide is also referred to as
Scopolamine-N-Butylbromide,
N-Butyl Scopolammonium Bromide,
and butylscopolamine.
Molecular formula C21H30BrNO4

20. After intravenous administration, the
substanceis rapidly distributed into
the tissues (t½ = 29 min)
It does not pass the blood-brain
barrier and plasmaprotein binding
is low
Metabolized in the liver, with the
half-life of the terminal elimination
phase being approximately 5 hours.
Approximately half the metabolites are
excreted in the urine.

22. Confirm The Safety And Efficacy
Lysine clonixinate (125 mg) and hyoscinbutylbromide (10 mg) capsules
30
sampel
Observation 4,46 years
Nausea (92%),
Vomit (92%),
General pain (82.1%)
Abdominal pain (85.7%)
And headache (46.4%)
Highly severe 10.7%
severe 42.9%
moderate 46.4%
1 patient
menstrual pain of moderate
intensity
3 patient
menstrual pain of Light
intensity
The association of a spasmolytic
analgesic reduces and prevents the
menstrual pain (colic) as well as the
associated manifestations with few
spasmolytic association is efficacy
and safety

24. lysine clonixinate (NSID) 125 mg plus propinox (Antispasmodic) 10 mg
VS
Paracetamol 500 mg plus hyoscine N-butylbromide (antispasmodic) 10 mg
VS
placebo
125
sampel
LC (NSID)+ Propinox (antispasm)
Paracetamol + HBB (antispasm)
Placebo
Significant by day 3 & 4
Significant at day 1

26. Antispasmodic(Drotaverine) and NSAID (Aceclofenac)
vs
NSAID (Aceclofenac) alone
200
sampel
100
Control
100
case

27. Komposisi Hyoscine N-Butylbromide 10 mg
Indikasi
Untuk meringankan spasme saluran gastrointestinal dan untuk
pencegahan dan pengobatan spasme dismenorrhae
Sediaan Tablet Salut Selaput
Dosis 2 tablet, 4 sehari
Kemasan Dus, 10 strip @ 10 tablet salut selaput, HNA Rp 170.000

28. TERIMA KASIH