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Dysmenorrhea

  • Gabriele Tridenti
  • Cristina Vezzani
Chapter

Abstract

Affecting up to 85% women, dysmenorrhea is the most frequent genital complaint in teenage and the main cause of school absenteeism, with important social relapses. Primary dysmenorrhea, namely, without underlying pelvic pathologies, occurs in 90% cases. Typically, it shows lower abdominal pains, requiring medications or limiting normal activities, starting with the onset of menses, strictly connected to ovulatory cycles and lasting no more than 2–3 days. It is due to the activation of prostaglandins (PGs) and leukotrienes (LTs) cascade in the uterine wall. Associated symptoms are frequent. Secondary dysmenorrhea, occurring in the remaining 10% cases, is later-onset and associated with well-defined pelvic pathologies, mainly endometriosis and obstructive genital anomalies. Diagnosis of primary dysmenorrhea is mostly clinical and ultrasonography may be useful to detect or to rule out secondary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) are first choice to be administered at full dose at the very onset of menstrual flow for no more than 2–3 days long. Oral contraceptives (OCs) are advisable after an unsuccessful 6 months treatment with NSAIDs. If OCs are also unsuccessful, diagnostic and operative laparoscopy is recommended to detect and treat secondary dysmenorrhea, mostly endometriosis and/or obstructive Mullerian anomalies. Non-medical options and complementary and alternative medicine are also discussed.

Keywords

Adolescence Dysmenorrhea Guideline Teenage Treatment 

Abbreviations

ACOG

American College of Obstetricians and Gynecologists

ESR

Erythrocyte sedimentation rate

FDA

Food and Drug Administration

Hz

Hertz

IRCCS

Istituto di Ricovero e Cura a Carattere Scientifico

LT

Leukotriene

NSAID

Non-steroidal anti-inflammatory drug

OC

Oral contraceptive

OHVIRA

Obstructed hemi vagina ipsilateral renal agenesis

PgE2

Prostaglandin E2

PgF

Prostaglandin F

PG

Prostaglandin

PID

Pelvic inflammatory disease

STD

Sexually transmitted disease

TENS

Transcutaneous electric nerve stimulation

VAS

Visual Analogue Score

VMS

Verbal Multidimensional Scoring System

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologySanta Maria Nuova Hospital—IRCCSReggio EmiliaItaly

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