Skip to Main Content

++

High-Yield Facts

++

  • The pain of dysmenorrhea may be experienced in the pelvis, lower back, or anterior thighs.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for dysmenorrhea.

  • In a normal menstrual cycle there is an average of 5 to 80 mL of blood loss.

  • Abnormal uterine bleeding (AUB) is a diagnosis of exclusion and involves any disturbance in regularity, frequency, duration, or volume of menstrual flow.

  • Up to 20% of adolescents with dysfunctional uterine bleeding will have a coagulopathy.

  • The hallmark of AUB is a negative pelvic examination.

++

Dysmenorrhea

++
Definition and Epidemiology
++

Dysmenorrhea is defined as cyclic menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified by pathophysiology (primary or secondary) or by intensity (mild, moderate, or severe) (Table 101-1).1 The term primary dysmenorrhea refers to pain with menses in the absence of pelvic pathology and typically begins early in adolescence once the regular ovulatory cycle has been established. Secondary dysmenorrhea is usually associated with underlying pelvic pathology, occurs at any time after menarche, and is most often seen in older women.2,3

++
Table Graphic Jump Location
TABLE 101-1   Classification of Dysmenorrhea 
++

The prevalence of primary dysmenorrhea is estimated to be 43% to 93% with 50% to 70% of adolescent women suffering from this debilitating condition.47 According to one study, only 14% of US adolescents, aged 12 to 17 years with dysmenorrhea, sought help from a physician. Self-treatment for dysmenorrhea is common among adolescent girls and young women, with 30% to 60% of girls report self-medicating with over-the-counter preparations.8

++

Dysmenorrhea has significant impact for both the individual and society. Approximately 38% of adolescents and 51% of young women describe severe symptoms, causing regular absenteeism from school and work respectively. This symptom burden, which interferes with work several days each cycle, has been estimated to account for 600 million lost working hours and 2 billion dollars in lost productivity annually in the United States.410

++

Pathophysiology

++

The cause of primary dysmenorrhea is unclear; however, the condition is associated with prostaglandin F2 release in the endometrium during menstruation. Sloughing endometrial cells release prostaglandins, causing myometrial contraction and vasoconstriction, which results in pain and cramping. The involvement of vasopressin is postulated to be increased ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.