– Tension & anxiety during adolescence, lower the pain threshold
– Uterine myometrial hyperactivity
– Over activity of the sympathetic nerves
– Increased production of prostaglandins
– Confined to adolescent girls
– It usually appeals within days of menarche
– Usually mother/sister may be dysmenorrhic
– The pain begins a few hours before or just with the onset of menstruation
– The pain usually lasts for few hours may extend to 24hours. But seldom persists beyond 24hours.
– Pain is spasmodic & confined to lower abdomen
– May radiate to back and medial aspect of thighs
– Systemic discomforts like:
6. Cold sweats
7. Fainting Investigations:
– For detection of any pelvic abnormalities
– Ultrasound is very useful
– Assurance, yoga, avoid salt, caffeine & alcohol
– Analgesic & antispasmodic drugs
– To empty the bowel
– Encourage normal activities If these steps fail, then you will be asked to go for a Usg
– To exclude any other pelvic pathology
Secondary Dysmenorrhea: (Congestive) Pain may be related to increasing tension in the pelvic tissues
1. Cervical stenosis
2. Chronic pelvic infection
3. Pelvic endometriosis
4. Pelvic adhesions
6. Uterine fibroid
7. Endometrial polyp
8. IUCD in utero
9. Pelvic congestion
Patient is usually in their thirties
– Usually seen in parous woman
– Dull, situated in the back & front without any radiation
– Usually appears 3-5 days prior the period and relieves with the start of bleeding
– There is no systematic discomfort unlike primary dysmenorrhea
– The patient may have got some discomfort even in between periods.
– Abdominal & vaginal examinations must to rule out pathology. Rx Treatment:
Depends on the cause rather than symptom.
– Type of Rx depends on the severing, age, parity of the patient
– Take home message & conclusion If you suspect that you have Dysmenorrhea, then you will be asked to take analgesics & antispasmodic drugs.
If they work, then it’s great. However, in case they fail, then you will be asked to go for a USG, which will give the doctor a clearer picture. If it comes out to be normal, then you can be reassured, but if it doesn’t, then the doctor will check for the underlying cause and then treat it.
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