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[Menstrual disorders in the general practice].

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Menstrual disorders are common yet often overlooked, impacting daily life significantly. General practitioners are crucial for early diagnosis and management, guiding patients toward appropriate treatments and specialist care when needed.

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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.