Abstract

A REVIEW ON EVALUATION, MANAGEMENT AND PATHOPHISIOLOGY OF DYSMENORRHEA

Aisha Ibrahim Salim Alsiyabi, A. R. Mullaicharam* and Nirmala Halligudi

Abstract

Menstrual cramps are throbbing or cramping pains in the lower abdomen. Many women experience menstrual cramps just before and during their menstrual periods. For some women, the discomfort is annoying can be severe enough to interfere with everyday activities for a few days every month. Dysmenorrhea is the most common gynecologic complaint among adolescent and young adult females. Dysmenorrhea in adolescents and young adults is usually primary (functional), and is associated with normal ovulatory cycles and with no pelvic pathology. In approximately 10% of adolescents and young adults with severe dysmenorrhea symptoms, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins and potent leukotrienes play an important role in generating dysmenorrhea symptoms. Nonsteroidal anti-inflammatory drugs (NSAID) are the most common pharmacologic treatment for dysmenorrhea. Adolescents and young adults with symptoms that do not respond to treatment with NSAIDs for 3 menstrual periods should be offered combined estrogen/progestin oral contraceptive pills for 3 menstrual cycles. Adolescents and young adults with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The care provider’s role is to explain about pathophysiology of dysmenorrhea to every adolescent and young adult female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.

Keywords: Primary dismenorrhoea, Age of menarche, daily activity steroidal antiinflammatory drugs (NSIDS).