DYSMENORRHEA

Types

Definition

Dysmenorrhea is characterized by severe and frequent menstrual cramps and pain during your period.

primary dysmenorrhea - occurs when you first start your period and continues throughout your life. It is usually life-long.

secondary dysmenorrhea - due to some physical cause. It usually starts later in life.

Risk Factor

  • Irregular menstrual cycle
  • Sexual abuse
  • Heavy menstrual lose
  • Low body mass index

Clinical Manifestation

  • Pain in your hips, lower back and inner thighs.
  • Nausea
  • Feeling of pressure in your abdomen.
  • Dizziness
  • Aching, throbbing pain in your abdomen (pain may be severe at times).
  • Headaches

Pathophysiology 🖊

  1. The endometrium thickens in preparation for potential pregnancy.
  1. After ovulation, if the ovum is not fertilized an there is no pregnancy, the build-up uterine tissue is not needed and thus shed.
  1. Molecular compounds called prostaglandins are released during menstruation.
  1. Release of prostaglandins and other inflammatory mediators in the uterus cause the uterus to contract.
  1. Also prostaglandins contricts the blood vessels which decreases blood supply to the tissue of the endometrium, which in turn, break down and dies.
  1. These contractions, and the resulting temporary oxygen deprivation to the nearby tissues, are response for the pains or cramps experienced during menstruation.

Investigation 🚩

History taking & Physical examination

Blood Test : Full Blood Count (FBC), Blood Urea Serum Electrolyte(BUSE), Electrolyte Sendimentation Rate (ESR)

Radiology & Imaging : X-ray, Ultrasound, CT Scan.

Differential Diagnosis

  • Endometriosis
  • Chronic Pelvic Inflammatory Disease
  • Adenomyosis
  • Intrauterine polyps
  • Fibroids

Management

Complication

  • Ectropic pregnancy
  • Infertility

Prognosis

can be cure with early treatment.

1. Medication

Analgesic - tab Paracetamol 1000mg TDS

Nsaids - tab Mefanamic Acid 250mg

Antiemetic - Domperidone 10mg TDS

2. Nursing care

  • Rest in bed according to supine or recumbent, semi flower and flower position.
  • Taking and monitoring vital sign such blood pressure, pulse rate, respiration rate,
    temperature and pain score for show progress toward recovery.
  • Insert and monitoring intravenous normal saline drip to avoid electrolyte imbalance.
  • Administration medication according to prescription such as right patient, right medication,
    right dosage, right route, right time, right documentation, right refuse.
  • Taking blood specimen and labeling sample for investigation purpose.
  • Record tracking and saving documentation for support diagnosis and as proof of activities.
  • Provide acupuncture
  • Provide heat bag

3. Health Education

  • Attending follow up treatment according to the time and date given by doctor.
  • Take the medication with correct dosage and timing according to doctor prescription such as 2 time per day (BD), 3 time per day (TDS), 4 time per day (QID), Immediately (Stat) and when necessary (PRN).
  • Consume a balance diet based on the food pyramid such as intake of high protein food, carbohydrate food, vegetables and fruits.
  • Encourage drinking 8 glasses of boiled water a day to prevent dehydration in the body.
  • Avoid drinking alcohol and smoking cigarettes because it can affect the health.
  • Practice a healthy and active lifestyle by doing light exercise such as jogging, walking, yoga
    and so on for a speedy recovery capabilities.
  • Exercise regularly
  • Get plenty of rest