Dysmenorrhea

1. Menstrual Disorders: Dysmenorrhea Health Services TasTAFE Health Services www.tastafe.tas.edu.au

2. Dysmenorrhea Dys menorrhea is a term describing painful menstruation that typically involves cramps caused by uterine contractions.

3. Dys menorrhea is divided into two categories: Primary dysmenorrhea Secondary dysmenorrhea Dys menorrhea :

4. 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. Dys menorrhea : The definition

5. S econdary dys menorrhea is: painful menstruation due to pelvic or uterine pathology. Dys menorrhea : The definition

6. Primary dysmenorrhea causes are: Dys menorrhea : Causes

7. Dys menorrhea : 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

8. 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 Dys menorrhea : Signs

9. A medical assessments should include: Patient history Physical examination Primary Dysmenorrhea cramping pain with menstruation and the physical examination is completely normal Secondary dysmenorrhea Dys menorrhea : Assessment 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

10. To treat p rimary dysmenorrhea : pain relief : NSAIDs, cyclooxygenase- 2 inhibitor hormonal contraceptives life style changes: daily ex. limit salty foods wt. loss smoking cessation relaxation techniques Dys menorrhea : Treatment

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