Dysmenorrhea is a medical condition that causes painful menstruation interfering with daily activities. It can feature sharp, throbbing, or dull pain in the lower abdomen that may precede or accompany menstruation. Dysmenorrhea is classified as primary, caused by excessive prostaglandins, or secondary, caused by underlying conditions like endometriosis. Common symptoms include abdominal pain, nausea, and fatigue. Treatment focuses on pain relief and includes NSAIDs, hormonal contraception, alternative therapies, and physical therapy.

1. DYSMENORRHEA
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 Dysmenorrhea is a medical condition
of pain during menstruation that
interferes with daily activities.
 Menstrual pain is often used
synonymously with menstrual cramps,
but the latter may also refer to
menstrual uterine contractions, which
are generally of higher strength,
duration and frequency

3.  Dysmenorrhea can feature different kinds of
pain, including sharp, throbbing, dull,
nauseating, burning, or shooting pain.
 Dysmenorrhea may precede menstruation by
several days or may accompany it, and it
usually subsides as menstruation tapers off.
 Dysmenorrhea may coexist with excessively
heavy blood loss, known as menorrhagia.

4.  It is extremely common in adolescent
girls
 About 90% of high school girls suffer
from this condition
 Many are unaware of this condition and
effective solution for the same

5. CLASSIFICATION
 Dysmenorrhea can be classified as
either primary or secondary based on
the absence or presence of an
underlying cause.
 Secondary dysmenorrhea is
dysmenorrhea which is associated with
an existing condition.

6. Causes of secondary dysmenorrhea
 The most common cause of secondary
dysmenorrhea is endometriosis
 Other causes include
1. Pelvic congestion
2. Ovarian cysts
3. Adenomyosis

7. Pathology of primary dysm.
 Due to excessive synthesis of
prostaglandins and also leukotrines &
vasopressin
 These cause uterine hypercontractility
& ischaemic pain

8. Signs & symptoms
 The main symptom of dysmenorrhea is
pain concentrated in the
lower abdomen, in the umbilical region
or the suprapubic region of the
abdomen.
 It is also commonly felt in the right or
left abdomen.
 It may radiate to the thighs and
lower back.

9.  Symptoms often co-occurring with menstrual
pain include nausea and vomiting
 diarrhea or constipation,
 headache, dizziness, disorientation
 hypersensitivity to sound, light, smell and
touch,
 fainting, and fatigue.
 Symptoms of dysmenorrhea often begin
immediately following ovulation and can last
until the end of menstruation.

10. Diagnosis
 Medical history
 Pain history
 Pelvic exam
 Pap test
 In some cases laproscopy

11. Management
 NSAIDs are effective in relieving the
pain of primary dysmenorrhea
 hormonal contraception can improve or
relieve symptoms of primary
dysmenorrhea
 70-90% cases of adolescent primary
cases respond well to prostaglandin
inhibitors.

12. Alternative therapies
 Hypnosis
 Acupuncture
 Behaviour modification therapies
 Diet rich in omega-3 fatty acids, vitamin
E, vitamin B6

13. PT MANAGEMENT
 Focuses on pain relief
 Topical heat
 TENS
 Spinal manipulation to treat spinal
subluxation (2006 systematic review
found that overall no evidence)

14. Level of consciousness