Diagnosis and initial management of dysmenorrhea

Amimi S. Osayande, Suarna Mehulic

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients' quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primary dysmenorrhea is menstrual pain in the absence of pelvic pathology. Abnormal uterine bleeding, dyspareunia, noncyclic pain, changes in intensity and duration of pain, and abnormal pelvic examination findings suggest underlying pathology (secondary dysmenorrhea) and require further investigation. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. Endometriosis is the most common cause of secondary dysmenorrhea. Symptoms and signs of adenomyosis include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Management options for primary dysmenorrhea include nonsteroidal anti-inflammatory drugs and hormonal contraceptives. Hormonal contraceptives are the first-line treatment for dysmenorrhea caused by endometriosis. Topical heat, exercise, and nutritional supplementation may be beneficial in patients who have dysmenorrhea; however, there is not enough evidence to support the use of yoga, acupuncture, or massage.

Original languageEnglish (US)
Pages (from-to)341-346
Number of pages6
JournalAmerican Family Physician
Volume89
Issue number5
StatePublished - Mar 1 2014

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Dysmenorrhea
Gynecological Examination
Endometriosis
Contraceptive Agents
Pathology
Adenomyosis
Yoga
Dyspareunia
Menorrhagia
Pain
Pelvic Pain
Massage
Uterine Hemorrhage
Acupuncture
Signs and Symptoms
Physical Examination
Uterus
Ultrasonography
Anti-Inflammatory Agents
Hot Temperature

ASJC Scopus subject areas

  • Family Practice

Cite this

Diagnosis and initial management of dysmenorrhea. / Osayande, Amimi S.; Mehulic, Suarna.

In: American Family Physician, Vol. 89, No. 5, 01.03.2014, p. 341-346.

Research output: Contribution to journalArticle

Osayande, Amimi S. ; Mehulic, Suarna. / Diagnosis and initial management of dysmenorrhea. In: American Family Physician. 2014 ; Vol. 89, No. 5. pp. 341-346.
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