| ID | 306 |
|---|---|
| Name | DYSMENORRHOEA |
| Cause | Causes: Primary dysmenorrhoea: Several factors may beresponsible- 1. Genetic factor. 2. Environmental factor e.g. anxiety, worries, unhappiness, unsatisfied sex urge etc. 3. General ill-health. 4. Pinhole internal os. 5. Increase secretion of prostaglandin. 6. Effect of progesterone. 7. Uterine hypoplasia and ischemia. Secondary dysmenorrhoea: See below under secondary dysmenorrhoea |
| Signs Symptoms | |
| Diagnosis | |
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| Management | |
| Introduction | |
| History | |
| Etiology | |
| Clinical Features | Clinical f eatures: Severe colicky pain which arises in the uterus and felt in the hypogastrium a few hours before and after menstruation. There may be sweating, pallor, nausea, vomiting, diarrhoea, tenesmus, and frequency of micturition. Pain referred to inner aspect of the thigh and rarely last longer than 12 hours. |
| Preventions | |
| Treatment | Treatment: 1. Assurance. 2. If unmarried- advice to marry & to have child. 3. Correction of unfavourable environmental circumstances, general ill-health, anemia etc. 4 Antispasmodic for relief of pain. 5. Oral contraceptive pill from 5th to 25th day of cycle, combined pill or oestrogen alone may be given. The cyclical therapy should be continued for 6-12 months. 6. Sedative, analgesics may given. If medical treatment fails then- 1. Dilatation of cervix. 2. Anesthetic injection into pelvic plexus may be beneficial. 3. Pre-sacral neurectomy. 4. When family complete, older ladies with adenomyosis- hysterectomy. |
| Complications | |
| Prognosis | |
| Types | Dysmenorrhoea means painful menstruation. Type of Dysmenorrhoea: 1. Primary or spasmodic dysmenorrhoea (true): Primary dysmenorrhea is menstrual pain, which is uterine in origin and directly due to menstruation, associated with ovulatory cycles in the absence of any pathologic findings. The pain usually begins within 1-2 years after the menarche and may become more severe with time. 2. Secondary or congestive dysmenorrhoea- Secondary dysmenorrhea is menstrual pain, which arises in an organ or tissue other than the uterus and is merely associated with menstruation. The pain usually begins well after menarche, even as late as third or fourth decade of life. |
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