Dysmenorrhoea
Definition
Painful menstruation.
1o/spasmodic = Begins 2-3y after menarche
2o = Acquired
Epidemiology
1o: 60-75% of 15-25y
2o: >35y
Aetiology
1o: imbalance of prostacyclin (vasodilation+myometrial relaxation), PGF2a (vasoconstriction+myometrial contraction), PGE2 (vasodilation+myometrial relaxation)
2o: Endometriosis, PID
Clinical Features
1o: Start 1d before menses, lasts 1-3d, 1st day worst
2o: Start 2d before menses, increasing severity, worst during late menses, then better
Management
Source
Llewellyn-Jones. 9th Ed. 2010
Painful menstruation.
1o/spasmodic = Begins 2-3y after menarche
2o = Acquired
Epidemiology
1o: 60-75% of 15-25y
2o: >35y
Aetiology
1o: imbalance of prostacyclin (vasodilation+myometrial relaxation), PGF2a (vasoconstriction+myometrial contraction), PGE2 (vasodilation+myometrial relaxation)
2o: Endometriosis, PID
Clinical Features
1o: Start 1d before menses, lasts 1-3d, 1st day worst
2o: Start 2d before menses, increasing severity, worst during late menses, then better
Management
- OCP (suppress ovulation)
- NSAIDs (mefenamic acid, ibuprofen, diclofenac)
Source
Llewellyn-Jones. 9th Ed. 2010