Dysmenorrhea

Affecting up to 85% women, dysmenorrhea is the most frequent genital complaint in teenage and the main cause of school absenteeism, with important social relapses. Primary dysmenorrhea, namely, without underlying pelvic pathologies, occurs in 90% cases. Typically, it shows lower abdominal pains, requiring medications or limiting normal activities, starting with the onset of menses, strictly connected to ovulatory cycles and lasting no more than 2–3 days. It is due to the activation of prostaglandins (PGs) and leukotrienes (LTs) cascade in the uterine wall. Associated symptoms are frequent. Secondary dysmenorrhea, occurring in the remaining 10% cases, is later-onset and associated with well-defined pelvic pathologies, mainly endometriosis and obstructive genital anomalies. Diagnosis of primary dysmenorrhea is mostly clinical and ultrasonography may be useful to detect or to rule out secondary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) are first choice to be administered at full dose at the very onset of menstrual flow for no more than 2–3 days long. Oral contraceptives (OCs) are advisable after an unsuccessful 6 months treatment with NSAIDs. If OCs are also unsuccessful, diagnostic and operative laparoscopy is recommended to detect and treat secondary dysmenorrhea, mostly endometriosis and/or obstructive Mullerian anomalies. Non-medical options and complementary and alternative medicine are also discussed. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others Abbreviations - ACOG: - American College of Obstetricians and Gynecologists - ESR: - Erythrocyte sedimentation rate - FDA: - Food and Drug Administration - Hz: - Hertz - IRCCS: - Istituto di Ricovero e Cura a Carattere Scientifico - LT: - Leukotriene - NSAID: - Non-steroidal anti-inflammatory drug - OC: - Oral contraceptive - OHVIRA: - Obstructed hemi vagina ipsilateral renal agenesis - PgE2 : - Prostaglandin E2 - PgF2α : - Prostaglandin F2α - PG: - Prostaglandin - PID: - Pelvic inflammatory disease - STD: - Sexually transmitted disease - TENS: - Transcutaneous electric nerve stimulation - VAS: - Visual Analogue Score - VMS: - Verbal Multidimensional Scoring System

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Dysmenorrhea in adolescents and young adults: a review in different countries. Acta Biomed. 2016;87(3):233–46. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2018 Springer International Publishing AG About this chapter Cite this chapter Tridenti, G., Vezzani, C. (2018). Dysmenorrhea. In: Fulghesu, A. (eds) Good Practice in Pediatric and Adolescent Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-57162-1_5 Download citation DOI: https://doi.org/10.1007/978-3-319-57162-1_5 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-57161-4 Online ISBN: 978-3-319-57162-1 eBook Packages: MedicineMedicine (R0)