Options for When Simple Managements Are Not Enough

In: Dysmenorrhea and Menorrhagia · 2018 · pp. 149–157 · doi:10.1007/978-3-319-71964-1_11 · W2784213775
book-chapter OA: closed CC0
Full text JSON View on OpenAlex View at publisher
AI-generated summary by claude@2026-06+body, 2026-06-12

Non-prescription therapies effectively treat dysmenorrhea, but prescription interventions and hormonal IUDs offer robust solutions for more severe menstrual pain and heavy bleeding.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This Springer chapter reviews management options for dysmenorrhea and heavy menstrual bleeding, outlining a stepwise approach from non-prescription measures to prescription interventions, at a high level drawing on trials and guideline-relevant evidence. A central finding emphasized is that hormone-releasing intrauterine devices (LNG-IUS) can provide durable efficacy for heavy menstrual bleeding for at least 5 years with continued user independence after placement. The chapter’s limitation is that it is a narrative chapter synthesizing existing studies rather than presenting original patient-level data, and it provides broad recommendations without detailing specific inclusion criteria or effect sizes for every cited modality. Relevance to endometriosis: it cites randomized trial evidence on depot leuprolide for chronic pelvic pain with clinically suspected endometriosis and ACOG guidance on endometriosis management, though the chapter’s main focus is dysmenorrhea and heavy menstrual bleeding treatment options rather than endometriosis specifically.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 7,883 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Both menstrual pain and heavy menstrual bleeding no longer represent the debilitating threat they once posed. Inexpensive, safe, effective non-prescription therapy available without medical consultation means that dysmenorrhea is no longer the source of disability it once was. When this is not enough, prescription interventions offer exceptional efficacy. When heavy menstrual bleeding is experienced, the placement of a hormone-releasing intrauterine device (LNG-IUS) offers efficacy for 5 or more years with no further actions by the user. Normality can be restored, worry relieved, and function maintained. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

De Sanctis V, Soliman A, Bernasconi S, et al. Primary dysmenorrhea in adolescents: prevalence, impact and recent knowledge. Pediatr Endocrinol Rev. 2015;13(2):512–20. Derry CJ, Derry S, Moore RA. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev. 2014;(12):CD009281. Lee B, Hong SH, Kim K, et al. Efficacy of the device combining high-frequency transcutaneous electrical nerve stimulation and thermotherapy for relieving primary dysmenorrhea: a randomized, single-blind, placebo-controlled trial. Eur J Obstet Gynecol Reprod Biol. 2015;194:58–63. Igwea SE, Tabansi-Ochuogu CS, Abaraogu UO. TENS and heat therapy for pain relief and quality of life improvement in individuals with primary dysmenorrhea: a systematic review. Complement Ther Clin Pract. 2016;24:86–91. Yiu KW, Chan SS, Chung TK. Mothers’ attitude to the use of a combined oral contraceptive pill by their daughters for menstrual disorders or contraception. Hong Kong Med J. 2017;23(2):150–7. Harel Z, Riggs S, Vaz R, Flanagan P, Dunn K, Harel D. Adolescents’ experience with the combined estrogen and progestin transdermal contraceptive method Ortho Evra. J Pediatr Adolesc Gynecol. 2005;18(2):85–90. Ling FW, For the Pelvic Pain Study Group. Randomized controlled trial of depot leuprolide in patients with chronic pelvic pain and clinically suspected endometriosis. Obstet Gynecol. 1999;93:51–8. American College of Obstetricians and Gynecologists. Management of endometriosis. Practice Bulletin No. 113. Obstet Gynecol. 2010;116:223–36. Sulak PJ, Cressman BE, Waldrop E, Holleman S, Kuehl TJ. Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms. Obstet Gynecol. 1997;89(2):179–83. Wilkinson JP, Kadir RA. Management of abnormal uterine bleeding in adolescents. J Pediatr Adolesc Gynecol. 2010;23:S22–30. Lichten EM, Bombard J. Surgical treatment of primary dysmenorrhea with laparoscopic uterine nerve ablation. J Reprod Med. 1987;32:37–41. Vercellini P, Aimi G, Busacca M, et al. Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial. Fertil Steril. 2003;80(2):310–9. Proctor ML, Latthe PM, Farquhar CM, et al. Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2005;(4):CD001896. Latthe PM, Proctor ML, Farquhar CM, Johnson N, Khan KS. Surgical interruption of pelvic nerve pathways in dysmenorrhea: a systematic review of effectiveness. Acta Obstet Gynecol Scand. 2007;86(1):4–15. Webster JC. Diseases of women: a text-book for students and practitioners. Edinburgh & London: Young J. Pentland; 1898. p. 57. Fig. 29 Yen YK, Liu WM, Yuan CC, Ng HT. Addition of laparoscopic uterine nerve ablation to laparoscopic bipolar coagulation of uterine vessels for women with uterine myomas and dysmenorrhea. J Am Assoc Gynecol Laparosc. 2001;8(4):573–8. Juang CM, Chou P, Yen MS, et al. Laparoscopic uterosacral nerve ablation with and without presacral neurectomy in the treatment of primary dysmenorrhea: a prospective efficacy analysis. J Reprod Med. 2007;52:591–6. Chen FP, Chang SD, Chu KK, Soong YK. Comparison of laparoscopic presacral neurectomy and laparoscopic uterine nerve ablation for primary dysmenorrhea. J Reprod Med. 1996;41:463–6. Papasakelariou C. Long-term results of laparoscopic uterosacral nerve ablation. Gynaecol Endosc. 1996;5:177–9. Moawad NS, Santamaria E, Johnson M, Shuster J. Cost-effectiveness of office hysteroscopy for abnormal uterine bleeding. JSLS. 2014;18(3.) pii: e2014.00393 Di Spiezio SA, Spinelli M, Zizolfi B, Nappi C. Ambulatory management of heavy menstrual bleeding. Womens Health (Lond). 2016;12(1):35–43. DI Spiezio Sardo A, Ceci O, Zizolfi B, Nappi C, Bettocchi S. Office myomectomy. Minerva Ginecol. 2016;68(3):321–7. Wortman M. “See-and-treat” hysteroscopy in the management of endometrial polyps. Surg Technol Int. 2016;28:177–84. Keyhan S, Munro MG. Office diagnostic and operative hysteroscopy using local anesthesia only: an analysis of patient reported pain and other procedural outcomes. J Minim Invasive Gynecol. 2014;21(5):791–8. Cooper NA, Middleton L, Smith P, et al. OPT trial collaborative group. A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding. Gynecol Surg. 2016;13(4):313–22. Duplay S, Clado S. Traité d'Hystéroscopie, Instrumentation, Technique Opératoire, Études Cliniques. Rennes: Fr. Simon, Succ De A Le Roy, Impriveur Dreveté; 1898. p. 60. Davies J, Kadir RA. Heavy menstrual bleeding: an update on management. Thromb Res. 2017;151(Suppl 1):S70–7. Fergusson RJ, Lethaby A, Shepperd S, Farquhar C. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database Syst Rev. 2013;(11):CD000329. Marjoribanks J, Lethaby A, Farquhar C. Surgery versus medical therapy for heavy menstrual bleeding. Cochrane Database Syst Rev. 2016;(1):CD003855. Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). BMJ Clin Evid. 2011;2011. pii: 0814 Scarperi S, Pontrelli G, Campana C, et al. Laparoscopic radiofrequency thermal ablation for uterine adenomyosis. JSLS. 2015;19(4.) pii: e2015.00071 Additional Resources American College of Obstetricians and Gynecologists. Endometrial ablation. ACOG Practice Bulletin No. 81. Obstet Gynecol. 2007;109:1233–48. American College of Obstetricians and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. ACOG Practice Bulletin No. 96. Obstet Gynecol. 2008;112:201–7. Centini G, Troia L, Lazzeri L, Petraglia F, Luisi S. Modern operative hysteroscopy. Minerva Ginecol. 2016;68(2):126–32. Davies J, Kadir RA. Heavy menstrual bleeding: an update on management. Thromb Res. 2017;151(Suppl 1):S70–7. Gimpelson RJ. Office hysteroscopy. Clin Obstet Gynecol. 1992;35(2):270–81. Heikinheimo O, Fraser I. The current status of hormonal therapies for heavy menstrual bleeding. Best Pract Res Clin Obstet Gynaecol. 2017;40:111–20. Kwok A, Lam A, Ford R. Laparoscopic presacral neurectomy: a review. Obstet Gynecol Surv. 2001;56(2):99–104. Kumar V, Chodankar R, Gupta JK. Endometrial ablation for heavy menstrual bleeding. Womens Health (Lond). 2016;12(1):45–52. Maybin JA, Critchley HO. Medical management of heavy menstrual bleeding. Womens Health (Lond). 2016;12(1):27–34. Ray S, Ray A. Non-surgical interventions for treating heavy menstrual bleeding (menorrhagia) in women with bleeding disorders. Cochrane Database Syst Rev. 2016;(11):CD010338. Author information Authors and Affiliations Rights and permissions Copyright information © 2018 Springer International Publishing AG About this chapter Cite this chapter Smith, R.P. (2018). Options for When Simple Managements Are Not Enough. In: Dysmenorrhea and Menorrhagia. Springer, Cham. https://doi.org/10.1007/978-3-319-71964-1_11 Download citation DOI: https://doi.org/10.1007/978-3-319-71964-1_11 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-71963-4 Online ISBN: 978-3-319-71964-1 eBook Packages: MedicineMedicine (R0)

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (29)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK