Primary Dysmenorrhea: Assessment and Treatment

Area of Science:

• Gynecology
• Pain Management
• Women's Health

Background:

• Primary dysmenorrhea is menstrual pain without pelvic disease, caused by prostaglandin overproduction leading to uterine ischemia.
• It is the most common gynecological illness in reproductive-aged women, frequently causing pelvic pain.
• Despite its prevalence and impact on quality of life (absenteeism, stress), it is often underdiagnosed and undertreated.

Purpose of the Study:

• To define primary dysmenorrhea and its underlying pathophysiology.
• To highlight its significant impact on daily activities and psychological well-being.
• To outline diagnostic criteria and treatment strategies.

Main Methods:

• Diagnosis is primarily clinical, based on patient history and a normal physical examination.
• Exclusion of secondary causes of dysmenorrhea is crucial.
• Treatment approaches include pharmacological, non-pharmacological, and surgical options.

Main Results:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line pharmacological treatment.
• Hormonal contraceptives are an option for women seeking contraception.
• Alternative therapies (heat, lifestyle changes, TENS, supplements, acupuncture) can be used when conventional treatments are contraindicated.

Conclusions:

• Primary dysmenorrhea significantly affects quality of life and productivity.
• Clinical diagnosis relies on history and examination, excluding secondary causes.
• A tiered treatment approach, starting with NSAIDs or hormonal contraceptives, is recommended, with alternative therapies for specific cases. Surgical intervention is reserved for refractory cases.