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Dysmenorrhea

Maggie C. Wertz, MD Reviewed 06/2019
 


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

Insufficient evidence for any specific dietary changes 

PATIENT EDUCATION

Reassure the patient that primary dysmenorrhea is treatable with the use of NSA...

REFERENCES

1
Burnett M, Lemyre M. No. 345—primary dysmenorrhea consensus guideline. J Obstet Gynaecol Can.  2017;39(7):585–595. [View Abstract on OvidMedline]
2
Osayande AS, Mehulic S. Diagnosis and...

ADDITIONAL READING

  • Ryan SA. The treatment of dysmenorrhea. Pediatr Clin North Am.  2017;64(2):331–342. [View Abstract on OvidMedline]

  • Shetty GB, Shetty B, Mooventhan A. Efficacy of acupuncture in ...

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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