Premenstrual syndrome and dysmenorrhea in adolescents

PMS/PMDD is a pervasive problem with a significant impact on the quality of life of affected individuals. This condition most often begins in adolescence with the establishment of normal ovulatory menstrual cycles; however, the underlying pathophysiology has yet to be delineated. Prospective evaluation is key to the confirmation of the diagnosis before the initiation of pharmacotherapy, especially psychotropic therapies, due to the possibly harmful side effect profile for adolescents compared to adults. Similarly, dysmenorrhea is common in adolescents. Although the majority of cases are primary, the HCP must be vigilant to allow for early diagnosis and treatment of secondary causes, thereby preventing long-term sequelae of delayed diagnosis. Stepwise therapy for dysmenorrhea treatment is usually employed; the choice of therapy should account for contraceptive needs of the adolescent in addition to symptom relief. For both PMSS/PMDD and dysmenorrhea, most studies of therapy have been performed in adults and, as such, adolescent-specific trials are required to confirm applicability to this age group.