Introduction.
Classification.
Clinical features.
Diagnosis.
Management.
Painful menstrual period, characterized by cramping lower abdominal pain radiating to the back and legs, often accompanied by GI & neurological symptoms as well as general malaise.
Affects approximately 50% of menstruating women, but about 5-10% have severe dysmenorrhea affecting daily activities.
Dysmenorrhoea is cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs, occurring before or during menstruation, or both.
The actual term dysmenorrhoea is derived from the Greek words
dys, meaning difficult, painful or abnormal,
meno, meaning month, and
rrhea, meaning flow
Classification:
I.Primary or idiopathic à without pelvic pathology.
II.Secondary à underlying pelvic pathology.
Clinical features of Primary dysmenorrhea:
Pain usually begins a few hours prior to or just after the onset of period & may last as long as 48-72 hrs.
Labor-like pains with suprapubic cramping, lumbosacral backache radiating down the anterior thigh.
Colicky pain improved with massage, counterpressure or movement.
Nausea, vomiting, diarrhea with rarely syncopal episodes.
Normal findings except some tenderness.
Conclusions:
Dysmenorrhoea has a significant physical,behavioural,psychological and social impact, affecting 40–70% of women of reproductive age.
It is a leading cause of absenteeism.
The exact pathophysiological processes are not fully understood but it probably reflects increased myometrial activity induced by an excessive production of prostaglandin causing ischemia.
Mainstay treatment is generally supportive providing symptomatic relief and more directive surgical treatment should be reserved for specific secondary causes of dysmenorrhoea or for refractory cases.