Dysmenorrhea in adolescents and young adults: an update on pharmacological treatments and management strategies

Zeev Harel
Expert opinion on pharmacotherapy · 2012 · vol. 13(15) , pp. 2157–2170 · doi:10.1517/14656566.2012.725045 · PMID:22984937 · W2172260642
review OA: closed CC0 ⤵ 27 in-corpus citations
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This review updates dysmenorrhea management, recommending NSAIDs as first-line, hormonal treatments for unresponsive cases, and laparoscopy to investigate endometriosis if symptoms persist.

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Abstract

INTRODUCTION: Dysmenorrhea is the most common gynecologic complaint among adolescents/young adults. Dysmenorrhea is usually primary and is associated with normal ovulatory cycles and with no pelvic pathology. Potent prostaglandins and potent leukotrienes play an important role in generating primary dysmenorrhea symptoms. Adolescents/young adults with severe dysmenorrhea symptoms may have pelvic abnormalities, such as endometriosis or uterine anomalies (secondary dysmenorrhea). AREAS COVERED: This review provides an update on treatments and management strategies of dysmenorrhea in adolescents/young adults. Medical literature articles were retrieved using a Medline search on primary and secondary dysmenorrhea. Original articles from peer-reviewed journals were selected based on relevance. EXPERT OPINION: Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) is the preferred initial treatment for dysmenorrhea in nonsexually active adolescents/young adults. Adolescents/young adults with symptoms that do not respond to NSAIDs for three menstrual periods should be offered hormonal treatment, such as combined estrogen and progestin oral contraceptive pills (OCPs), for three menstrual cycles. If dysmenorrhea does not improve within 6 months of NSAIDs and OCPs, a laparoscopy is indicated to look for endometriosis, which is the most common reason for secondary dysmenorrhea.

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Condition tags

mesh:D004412mesh:D004715endometriosisdysmenorrhea

MeSH descriptors

Dysmenorrhea Adolescent Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents, Non-Steroidal Contraceptives, Oral Contraceptives, Oral Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Endometriosis Female Humans Young Adult

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 (100)

Cited by (27)

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License: CC0 · commercial use OK