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Dysmenorrhea

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Pelvic pain occurring at/around time of menses; a leading cause of absenteeism for women <30 years old

  • Primary dysmenorrhea: pelvic pain without pathologic physical findings

  • Seconda...

DIAGNOSIS

Based on characteristic history of suprapubic/low back cramping/pain occurring at or near menstrual flow onset lasting for 8 to 72 hours (2

HISTORY

  • Primary: Onset once ovulatory cycles are e...

TREATMENT

  • Reassure the patient that treatment success is very likely with adherence to recommendations.

  • Relief may require the use of several treatment modalities at the same time.

GENERAL MEASURES

  • Exerc...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Normal 

DIET

  • Vitamin B1 100 mg daily, ω-3 fatty acid, and fish oil supplementation may be beneficial.

  • Magnesium has been shown to be useful, but the correct dosage h...

REFERENCES

1
1 Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiol Rev.  2014;36:104–113. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Osayande AS, Mehulic S...

ADDITIONAL READING

  • Akin MD, Weingand KW, Hengehold DA, et al. Continuous low-level topical heat in the treatment of dysmenorrhea. Obstet Gynecol.  2001;97(3):343–349. {L-End} {L-End} [View Abs...

SEE ALSO

  • Dyspareunia; Endometriosis; Menorrhagia (Heavy Menstrual Bleeding); Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

  • Algorithm: Pelvic Pain

CODES

ICD10

  • N94.6 Dysmenorrhea, unspecified

  • N94.4 Primary dysmenorrhea

  • N94.5 Secondary dysmenorrhea

ICD9

625.3 Dysmenorrhea 

SNOMED

  • 266599000 Dysmenorrhea (disorder)

  • 65754002 Primary dysmenorrhea (disorder)

  • 32...

CLINICAL PEARLS

  • Dysmenorrhea is a leading cause of absenteeism for women age <30 years.

  • In women who desire contraception, hormonal contraceptives are the preferred treatment.

  • All NSAIDs studied have...

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