[Menstrual disorders in the general practice]

Area of Science:

• General Practice
• Women's Health
• Reproductive Endocrinology

Background:

• Menstrual disorders are frequent complaints impacting quality of life.
• These conditions are often under-recognized in primary care settings.
• Differentiating normal physiological variations from pathology can be challenging.

Purpose of the Study:

• To outline the role of general practitioners in managing menstrual disorders.
• To describe diagnostic work-up and first-line treatment strategies.
• To define criteria for referral to secondary care.

Main Methods:

• Diagnostic work-up involves patient history, menstrual calendar tracking, and ultrasound.
• Laboratory tests like hemoglobin/ferritin and coagulation screening are used when indicated.
• Treatment strategies encompass hormonal contraception, tranexamic acid, and NSAIDs.

Main Results:

• First-line treatments include combined oral contraceptive pills, progestogen-only preparations, and hormonal intrauterine devices.
• Non-steroidal anti-inflammatory drugs (NSAIDs) and tranexamic acid are also key first-line options.
• Referral to secondary care is necessary for treatment failures, suspected structural abnormalities, or severe anemia.

Conclusions:

• General practitioners are central to the identification, diagnosis, and initial management of menstrual disorders.
• A systematic approach combining history, diagnostics, and evidence-based treatments is essential.
• Timely referral ensures access to advanced pharmacological and minimally invasive options in secondary care.