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