DR FELICIA MOLOKOANE Dysmenorrhoea. Introduction Medical condition Characterized by severe uterine...
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Transcript of DR FELICIA MOLOKOANE Dysmenorrhoea. Introduction Medical condition Characterized by severe uterine...
DR FELICIA MOLOKOANE
Dysmenorrhoea
Introduction
Medical condition
Characterized by severe uterine pain during menses
Manifesting as cyclical lower abdominal pain
40 – 70% women suffer from this condition
Leading cause of absenteeism
Introduction
Exact cause is not fully understood
Classified into Primary: occurs in the absence of any underlying
diseases
Secondary: usually due to underlying pathology
Pathogenesis
Uterine hyperactivity
Prostaglandins
Vasopressin
Primary dysmenorrhoea
Usually start within 6 – 12 months after menarche, when ovulatory cycles are established
Symptoms begin a few hours before the start of menstruation
Often relieved during the 1st few days of bleeding
Primary dysmenorrhoea
There may be associated symptoms Headache, nausea, vomiting and diarrhoea
On examination there are no abnormal findings
Secondary dysmenorrhoea
Can occur at any time after menarche
Usually present after the 3rd and 4th decade of life
Causes Endometriosis Fibroids Adenomyosis Endometrial polyps PID
Investigations
No investigation is necessary for 1° dysmenorrhoea
2° dysmenorrhoea Pelvic ultrasound Swabs for chlamydia Laparoscopy if suspicious of endometriosis
Treatment of 1° dysmenorrhoea
NSAIDs Inhibit the prostaglandin synthesis, and decrease
uterine contractility Can reduce pain up to 70%
Other analgesia
COCs
Treatment of 1° dysmenorrhoea
Mirena
Transcutaneous electrical nerve stimulation
Locally applied heat
Acupuncture
Laparoscopic uterine nerve ablation
Treatment of 2° dysmenorrhoea
Treat the cause