Dysmenorrhea



Definition
Dysmenorrhea:
Pain comes with menses, gone after menses
-Adolescent female who has started periods
-Started periods within last 2yr
- CRAMPING
- > 20 yr old
- DULL, ACHING pain
Primary Dysmenorrhea Secondary Dysmenorrhea
- N/V/D
- (-) pelvic pathology

 

Treatment:
1. NSAIDs
2. Continuous OCP

Endometriosis Adenomyosis Leiomyoma Chronic PID
- Endometrial glands & stroma OUTSIDE uterus
- RETROGRADE menses to Ovary & culde-sac
- Uterosacral ligament nodularity
- Pain w/ sex & BM
- Infertility
- Symmetric enlargment
- Soft
-Tender

AdenoMYOMA:
Localized

AdenoMYOSIS:
Diffuse
-Asymmetric enlargement
-Firm
-Non-tender
- Chronic BL pain
- (+) Cervial Motion Tenderness.
Treatment:
Continuous Medroxyprogesterone
Combined OCP

Danocrine
Leuprolide
Treatment:
IUD to decrease bleeding
OR
Hysterectomy
  Treatment:
Levaquin
+
Azithromycin
+
Flagyl