Dysmenorrhoea Flashcards Preview

A - MSRA Gynaecology > Dysmenorrhoea > Flashcards

Flashcards in Dysmenorrhoea Deck (38)
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1
Q

What is dysmenorrhoea?

A

Painful menstruation

2
Q

How common is dysmenorrhea?

A

The most common gynaecological symptom

3
Q

What sort of pain is dysmenorrhoea typically?

A

Colicky pain that starts with the onset of bleeding

4
Q

When is dysmenorrhoea usually at its most painful?

A

In the first few days of the period

5
Q

What is primary dysmenorrhoea?

A

Dysmenorrhoea in the absence of any significant pelvic pathology

6
Q

What causes primary dysmenorrhoea?

A

Excessive myometrial contractions producing uterine ischaemia in response to local prostaglandins from the endometrium

7
Q

When does dysmenorrhoea usually develop?

A

6 months - 2 years after menarche

8
Q

Who is dysmenorrhoea usually more frequent or severe in?

A

Women whose period starts at an early age

9
Q

Is there a familial component to dysmenorrhoea?

A

Yes

10
Q

What are the associated symptoms of dysmenorrhoea?

A
  • Nausea
  • Vomiting
  • Diarrhoea
  • Dizziness
11
Q

How can dysmenorrhoea affect a woman’s social life?

A

It can affect it negatively - I’m so done with these cards ngl

12
Q

What is the pattern of dysmenorrhoea pain?

A

Ovulatory cycles

13
Q

Where does the pain of dysmenorrhoea usually occur?

A

Lower abdominal and pelvic

14
Q

Where can dysmenorrhoea sometimes radiate to?

A

The anterior aspects of the thighs

15
Q

When can dysmenorrhoea often resolve?

A

After the birth of the first child

16
Q

What is secondary dysmenorrhoea?

A

Dysmenorrhoea associated with some form of pelvic pathology

17
Q

When is the usual onset of secondary dysmenorrhoea?

A

After menarche

18
Q

When does the pain of secondary dysmenorrhoea usually occur?

A

Several days prior to the period

19
Q

What sort of pain is seen in secondary dysmenorrhoea?

A

Heavy, dragging nature

20
Q

Where can secondary dysmenorrhoea radiate to?

A
  • Back
  • Loins
  • Leg
21
Q

What are the potential causes of secondary dysmenorrhoea?

A
  • Endometriosis
  • Fibroids
  • Adenomyosis
  • Pelvic infections
  • Adhesions
  • Developmental anomalies
22
Q

What features if dysmenorrhoea is it important to find out in a history?

A
  • Timing of onset
  • Characteristics
  • Associated symptoms
23
Q

What associated symptoms should be asked about in a patient presenting with dysmenorrhoea?

A
  • Dysuria

- Dyspareunia

24
Q

What should the decision to perform pelvic examination in dysmenorrhoea be based on?

A
  • Sexual activity
  • Need for a Pap smear
  • Whether it is likely to be primary dysmenorrhoea
25
Q

What is normally seen in primary dysmenorrhoea on examination?

A

Normal findings

26
Q

What should be assessed for on examination in secondary dysmenorrhoea?

A
  • Uterine and adnexal tenderness
  • Masses
  • Uterine mobility
  • Posterior fornix and cervical movement pain
27
Q

What investigations should be performed in dysmenorrhoea?

A
  • Swabs

- Pelvic USS

28
Q

What is pelvic USS good for detecting in dysmenorrhoea?

A

Fibroids

29
Q

What will not commonly be detected by pelvic USS in dysmenorrhoea?

A
  • Adenomyosis

- Endometriosis

30
Q

What investigation is given to women with dysmenorrhoea who have persistent or progressive pain and are unresponsive to treatment?

A

Diagnostic laparoscopy

31
Q

What is often a useful step in managing primary dysmenorrhoea?

A

Explaining that there is not underlying pathology and how the pain is being caused

32
Q

What are some non-medical interventions used to treat dysmenorrhoea?

A
  • Stopping smoking
  • Exercise
  • Using heat pack on lower abdomen
  • Vitamin B1 supplementation
33
Q

What is the most commonly used pharmacological treatment for dysmenorrhoea?

A

NSAIDs

34
Q

When should patients with dysmenorrhoea be offered COCP?

A

After 3 menstrual periods with no response to NSAIDs

35
Q

How does the COCP help with dysmenorrhoea?

A

It reduces the uterine prostaglandin release

36
Q

What should the patient get if they do not respond to COCP for dysmenorrhoea?

A

Evaluation for structural or infective cause

37
Q

What does the treatment for secondary dysmenorrhoea depend on?

A

Underlying cause

38
Q

How may extreme cases of secondary dysmenorrhoea be relieved?

A

Hysterectomy