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
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.
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
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.
Causes of secondary dysmenorrhea
The most common cause of secondary
dysmenorrhea is endometriosis
Other causes include
1. Pelvic congestion
2. Ovarian cysts
3. Adenomyosis
Pathology of primary dysm.
Due to excessive synthesis of
prostaglandins and also leukotrines &
vasopressin
These cause uterine hypercontractility
& ischaemic pain
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.
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.
Diagnosis
Medical history
Pain history
Pelvic exam
Pap test
In some cases laproscopy
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.
Alternative therapies
Hypnosis
Acupuncture
Behaviour modification therapies
Diet rich in omega-3 fatty acids, vitamin
E, vitamin B6
PT MANAGEMENT
Focuses on pain relief
Topical heat
TENS
Spinal manipulation to treat spinal
subluxation (2006 systematic review
found that overall no evidence)
Level of consciousness