Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. There are two types - primary dysmenorrhea, which is caused by uterine contractions, and secondary dysmenorrhea, which is caused by underlying medical conditions. Symptoms include lower abdominal pain that may radiate to the thighs and back, along with nausea, vomiting, diarrhea, and headaches. Treatment involves NSAIDs to reduce prostaglandins and relieve pain, oral contraceptives, and lifestyle changes like exercise and hot baths.

1. MENSTURAL DISORDERS
DYSMENORRHEA
PRESENTED BY:
SUVETHA.G
TUTOR
VMCON.

2. DEFINITION:
•Dysmenorrhea is Menstural condition
characterized by severe and frequent
menstural cramps and pain associated
with mensuration.
•Pain tends to peak 24 hours after onset
of menses and subside after 2 to 3
days.

3. •It is usually sharp but may be cramping,
throbbing or dull constant ache, it may
radiate to the legs.
•While most women experience minor pain
during mensuration, dysmenorrhea is
diagnosed when the pain is so severe so
as to limit normal activities or require
medications.

4. TYPES OF DYSMENORRHEA :
1.Primary Dysmenorrhea :
Often it begins soon after a pre-teen or
teen starts having periods.
Pain is severe and frequent menstural
cramping caused by severe and abnormal
uterine contractions.
RISK FACTORS :
•Early age at menarche< 12 years
•Nullipara
•Heavy or prolonged menstural flow

5. • Smoking
• Alcohol
• Positive family history
• Obesity or overweight.
SYMPTOMS:
• Backache
• Leg pain
• Nausea
• Vomiting
• Diarrhea
• Headache and dizziness.

6. 2.Secondary Dysmenorrhea :
secondary Dysmenorrhea is cramps caused by anathor
medical problems such as endometriosis, adenomyosis,
pelvic inflammatory disease, uterine fibroids, cervical
narrowing, uterine malposition, tubo-ovarian abscess,
ovarian cyst, pelvic tumors or an IUD intra uterine devices.
This condition usually occurs in older women.
It usually begins well after the age of onset of
mensuration, sometimes as late as tge third or fourth
decade of life.

7. PATHOPHYSIOLOGY:
Molecular compounds called prostaglandins are
released during mensuration, due to the destruction of
endometrial cells and resultant release of their contents.
Released prostaglandins and other inflammatory
mediators causes uterus to contract and
resulting in temporary oxygen deprivation to nearby
tissues which causes pain
These substances are thought to be a major factor
in primary Dysmenorrhea

8. CLINICAL MANIFESTATION:
• Symptoms of Dysmenorrhea often begin
immediately following ovulation amd can last until
the end of mensuration
• This is because Dysmenorrhea is often associated
with changes un Harmonal levels in body that
occur with ovulation.
• The main symptom of Dysmenorrhea is pain
concentrates in the lower abdomen, in the
umbilical region or suprapubic region of the
abdomen
• It may radiate to thighs and lower back

9. • Other symptoms includes nausea and
vomiting
• Diarrhea or constipation
• Headache
• Dizziness
• Disorientation
• Hypersensitivity to sound,light,smell and
touch
• Fainting
• Fatigue

10. DIAGNOSTIC EVALUATION :
• Medical history
• Complete physical examination including a pelvic
examination.
• A diagnosis of Dysmenorrhea can only be certain
when the physician rules out other menstural
disorders, Medical condition or medications that
may cause or aggravating the condition.
• Ultrasound
• MRI (magnetic resonance imaging)

11. MANAGEMENT :
• For treatment of primary Dysmenorrhea
antiprostaglandin drugs or NSAIDS such as
aspirin, ibuprofen, ketoprofen or naproxen.
• These drugs inhibit synthesis of prostaglandins,
lessen the contractions of uterus and reduces
the menstural flow.
• These drugs should be started at the onset of
bleeding and taken foe 2-3 days.
• Oral contraceptives are anathor alternative.
These drugs stops ovulation and decrease
prostaglandin levels,which may eliminate

12. • Treatment of secondary Dysmenorrhea
depends on the cause.
• Treatment methods may vary from
conservative drug therapy to surgical
procedures.
• Several nutritional supplements have been
indicated as effective in treating
Dysmenorrhea including omega 3 fatty acids,
magnesium, vitamin E, zinc and
thiamine( vitaminB1).
• Non drug therapies are also suggested

13. NURSING MANAGEMENT :
• Advice the patient to take hot bath which helps
in realaxtion of uterus and reduces pain
• Place a heating pad on abdomen ,the flow of
heat can provide soothing, temporary pain
relief.
• Advice to do regular exercise including walking