DYSMENORRHOEA

DEFINITION

Cramps and pelvic pain with menstruation.

CAUSES

heavy flow

passing clots

uterine fibroids

endometriosis

CLINICAL MANIFESTATIONS

headaches.

nausea and vomiting.

digestive problems, such as diarrhoea or constipation.

fainting.

premenstrual symptoms, such as tender breasts and a swollen abdomen, which may continue throughout the period.

NURSING MANAGEMENT

Non-steroidal anti-inflammatory drugs

Oral contraceptive pill

Transdermal glyceryl trinitrate, which relaxes uterine contractions, can be used to treat dysmenorrhoea.

Acupuncture gives relief from pain and has been found to be effective for the treatment of dysmenorrhoea.

RISK FACTORS

Early age at menarche (< 12 years)

Nulliparity.

Heavy or prolonged menstrual flow.

Smoking.

Positive family history.

Obesity.

PATHOPHYSIOLOGY

Prostaglandins seem to be involved to a large extent in the development of the myometrial hyperactivity. Other mechanisms of possible importance such as ovarian hormones, cervical factors, vasopressin, nerves, and psychological factors can well act ultimately through prostaglandin release but an action directly on the myometrium and blood flow may also occur.