1. Menstrual Disorders:
Dysmenorrhea
Health Services
TasTAFE Health Services
www.tastafe.tas.edu.au
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2. Dysmenorrhea
Dysmenorrhea is a term describing painful
menstruation that typically involves cramps
caused by uterine contractions.
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3. Dysmenorrhea:
Dysmenorrhea is divided into two
categories:
1. Primary dysmenorrhea
2. Secondary dysmenorrhea
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4. Dysmenorrhea: The definition
Primary dysmenorrhea is:
 caused by increased prostaglandin production by the
endometrium in an ovulatory cycle which cause
contraction of the uterus.
Note: The highest level is in the first 2 days of menses.
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5. Dysmenorrhea: The definition
Secondary dysmenorrhea is:
 painful menstruation due to pelvic or uterine
pathology.
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6. Dysmenorrhea: Causes
Primary dysmenorrhea causes are:
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7. Dysmenorrhea: Causes
Secondary dysmenorrhea causes are:
 Endometriosis: ectopic implantation of the
endometrial tissue in other parts of the pelvic,
it’s the most common cause of dysmenorrhea
 Adenomiosis: ingrowth of the endometrium into
the uterine musculature.
 Fibroids
 Pelvic infection
 Intrauterine device
 Cervical stenosis
 Congenital uterine or vaginal abnormalities
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8. Dysmenorrhea: Signs
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sharp, intermittent spasm, usually in subrapupic area.
pain may radiate to the back of the leg or the lower back
systemic symptoms:
nausea
vomiting
diarrhea
fatigue
fever
Headache or dizziness
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9. Dysmenorrhea: Assessment
A medical assessments should include:
 Patient history
 Physical examination
Primary Dysmenorrhea
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cramping pain with menstruation and the physical examination is completely normal
Secondary dysmenorrhea
the history discloses cramping pain starting
after 25 years old with pelvic abnormality
history of infertility
heavy menstrual flow
irregular cycles
little or no response to NSAIDs
detailed sexual history to asses for
inflammation or scaring
bimanual pelvic examination in
nonmenstrual phase of the cycle
laboratory tests for:
CBC to R/O anemia
Urine analysis to R/O bladder infection
Pregnancy test
Cervical culture to exclude STI
ESR to detect an inflammatory process
Pelvic and vaginal U/S
Diagnostic laprascopy or lapratomy
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10. Dysmenorrhea: Treatment
To treat primary dysmenorrhea:
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pain relief : NSAIDs, cyclooxygenase- 2 inhibitor
hormonal contraceptives
life style changes:
daily ex.
limit salty foods
wt. loss
smoking cessation
relaxation techniques
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TasTAFE Health Services North. All content in this resource has been
produced by TasTAFE personnel and is made available to you for your
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