Abstract
Dysmenorrhoea, or painful menstruation, is categorized as primary (without pelvic pathology) or secondary (due to conditions like endometriosis, fibroids, or PID). Primary dysmenorrhoea usually presents with a normal pelvic exam, while secondary causes may show abnormalities. Management begins with NSAIDs and hormonal therapies; combined oral contraceptives are first-line for endometriosis-related pain. Non-pharmacologic options like heat therapy, exercise, and dietary supplements have limited evidence. Progestin-only methods are alternatives when estrogen is contraindicated. If symptoms persist after 3–6 months, diagnostic laparoscopy should be considered to identify underlying pathology. Treatment is tailored based on response, tolerability, and patient preference.
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References
American College of Obstetricians and Gynecologists. Dysmenorrhea and endometriosis in the adolescent, Number 760 [Internet]. 2018 [cited 2021 Apr 5]. Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/dysmenorrhea-and-endometriosis-in-the-adolescent
Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiol Rev. 2014;36:104.
Ju H, Jones M, Mishra GD. Smoking and trajectories of dysmenorrhoea among young Australian women. Tob Control. 2016;25:195–202.
Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhoea. Am Fam Physician. 2014;89(5):341–6.
Smith RP, Kaunitz AM. Dysmenorrhea in adult women: clinical features and diagnosis. UpToDate [cited 2021 Apr 18].
Sundell G, Milsom I, Andersch B. Factors influencing the prevalence and severity of dysmenorrhoea in young women. Br J Obstet Gynaecol. 1990;97:588.
Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1.
Barbieri RL, Propst AM. Physical examination findings in women with endometriosis: uterosacral ligament abnormalities, lateral cervical displacement, and cervical stenosis. J Gynecol Tech. 1999;5:157.
Propst AM, Storti K, Barbieri RL. Lateral cervical displacement is associated with endometriosis. Fertil Steril. 1998;70:568.
Barbieri RL, Callery M, Perez SE. Directionality of menstrual flow: cervical os diameter as a determinant of retrograde menstruation. Fertil Steril. 1992;57:727.
Chaudhuri A, Singh A, Dhaliwal L. A randomised controlled trial of exercise and hot water bottle in the management of dysmenorrhoea in school girls of Chandigarh, India. Indian J Physiol Pharmacol. 2013;57:114–22.
Pattanittum P, Kunyanone N, Brown J, et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev. 2016;2016(3):CD002124.
Harel Z. Dysmenorrhea in adolescents and young adults: an update on pharmacological treatments and management strategies. Expert Opin Pharmacother. 2012;13:2157–70.
Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;2015(7):CD001751.
Leyland N, Casper R, Laberge P, Singh SS, SOGC. Endometriosis: diagnosis and management. J Obstet Gynaecol Can. 2010;32(7 suppl 2):S1–S32.
Wong CL, Farquhar C, Roberts H, Proctor M. Oral contraceptive pill for primary dysmenorrhoea. Cochrane Database Syst Rev. 2009;2009(4):CD002120.
Audet MC, Moreau M, Koltun WD, et al. Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs an oral contraceptive: a randomized controlled trial. JAMA. 2001;285:2347.
ACOG Committee on Practice Bulletins--Gynecology. ACOG practice bulletin. Medical management of endometriosis. Number 11, December 1999 (replaces Technical Bulletin Number 184, September 1993). Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000;71(2):183–96. https://doi.org/10.1016/s0020-7292(00)80034-x.
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Selvarajan, A. (2025). Dysmenorrhea. In: Swarna Nantha, Y. (eds) Screen, Diagnose, Manage and Monitor. Springer, Singapore. https://doi.org/10.1007/978-981-97-7640-5_135
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DOI: https://doi.org/10.1007/978-981-97-7640-5_135
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