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Dysmenorrhea (or dysmenorrhoea) is a medical condition characterized by severe uterine pain during menstruation. While many individuals experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication. Image File history File links Question_book-3. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... Matrilineality is a system in which one belongs to ones mothers lineage; it may also involve the inheritance of property or titles through the female line. ... Look up Pain in Wiktionary, the free dictionary. ... Not to be confused with Mensuration. ... This article does not cite any references or sources. ...

Dysmenorrhea can feature different kinds of pain, including sharp, throbbing, dull, nauseating, burning, or shooting pain. Dysmenorrhea may precede menstruation by several days or may accompany it, and it usually subsides as menstruation tapers off. Dysmenorrhea may coexist with excessively heavy blood loss, known as menorrhagia. For other uses, see Blood (disambiguation). ... Menorrhagia is an abnormally heavy and prolonged menstrual period at regular intervals. ...

Primary dysmenorrhea is diagnosed when there are no other condition(s) of the uterus or other pelvic organs present. Secondary dysmenorrhea is diagnosed when symptoms are attributable to an underlying disease process, or structural abnormality either within or outside the uterus. This article is about female reproductive anatomy. ... This article is about the medical term. ...

Primary dysmenorrhea

Signs and symptoms

The main symptom of dysmenorrhea is pain centering in the lower abdomen, which may radiate to the thighs and lower back. Other symptoms may include nausea and vomiting, diarrhea, headache, and fatigue. Symptoms of dysmenorrhea usually begin a few hours before the start of menstruation, and may continue for a few days. For the human abdomen, see human abdomen. ... In humans the thigh is the area between the pelvis and buttocks and the knee. ... Illustration of a human back from Grays Anatomy. ... For other uses, see Nausea (disambiguation). ... Emesis redirects here. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Fatigue may refer to: Fatigue (physical) - tiredness in humans Fatigue (material) - failure by repeated stress in materials Fatigues (uniform) - military uniform (BDU or ACU) Chronic Fatigue Syndrome - a medical condition Battle fatigue - also known as Post-traumatic stress disorder Readers fatigue - a side-effect of parsing poorly formatted textual...

Etiology

Risk factors for primary dysmenorrhea include obesity, cigarette smoking, and positive family history.^{[citation needed]} In a systematic review, an age of less than 30 years, a low body mass index, smoking, earlier menarche (< 12 years), longer menstrual cycles, heavy menstrual flow, nulliparity, premenstrual syndrome, sterilisation, clinically suspected pelvic inflammatory disease, sexual abuse, and psychological symptoms were associated with dysmenorrhoea.^[1] In the same review, younger age at first childbirth, exercise, and oral contraceptives were negatively associated with dysmenorrhoea. Tobacco smoking is the act of smoking tobacco products, especially cigarettes and cigars. ... In medicine, a family history consists of information about disorders that a patients direct blood relatives have suffered from. ... A graph of body mass index is shown above. ... For the food preparation, see Smoking (cooking). ... Menarche (IPA: ) is the first menstrual period, or first menstrual bleeding in the females of human beings. ...

Pathophysiology

Prostaglandins are released during menstruation, due to the destruction of the endometrial cells, and the resultant release of their contents.^{[citation needed]} Release of prostaglandins and other inflammatory mediators in the uterus is thought to be a major factor in primary dysmenorrhea.^[2] Prostaglandin levels have been found to be much higher in females with severe menstrual pain than in females who experience mild or no menstrual pain.^{[citation needed]} Females with primary dysmenorrhea have increased activity of the uterine muscle with increased contractility and increased frequency of contractions.^{[citation needed]} E1 - Alprostadil I2 - Prostacyclin A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. ... The endometrium is the uterine membrane in mammals which is thickened in preparation for the implantation, of a fertilized egg upon its arrival into the uterus. ... A prostaglandin is any member of a group of lipid compounds that are derived from fatty acids and have important functions in the animal body. ... This article is about female reproductive anatomy. ...

Diagnosis

In one research study using MRI, visible features of the uterus were compared in dysmenorrheic and eumenorrheic (normal) participants. The study concluded that in dysmenorrheic patients, visible features on cycle days 1-3 correlated with the degree of pain, and differed significantly from the control group.^[3] The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ...

Treatment

Nutritional

Several nutritional supplements have been indicated as effective in treating dysmenorrhea, including omega-3 fatty acids, magnesium, vitamin E, zinc, and thiamine (vitamin B₁). A dietary supplement is intended to supply nutrients, (vitamins, minerals, fatty acids or amino acids) that are missing or not consumed in sufficient quantity in a persons diet. ...

Research indicates that one mechanism underlying dysmenorrhea is a disturbed balance between antiinflammatory, vasodilator eicosanoids derived from omega-3 fatty acids, and proinflammatory, vasoconstrictor eicosanoids derived from omega-6 fatty acids.^[4] Several studies have indicated that intake of omega-3 fatty acids can reverse the symptoms of dysmenorrhea, by decreasing the amount of omega-6 FA in cell membranes.^[5][6][7] The richest dietary source of omega-3 fatty acids is found in flax oil.^[8] A vasodilator is a drug or chemical that relaxes the smooth muscle in blood vessels, which causes them to dilate. ... In biochemistry, eicosanoids are a class of oxygenated hydrophobic molecules that largely function as autocrine and paracrine mediators. ... Omega-3 fatty acids are polyunsaturated fatty acids found in certain fish tissues, and in vegetable sources such as flax seeds, walnuts, and canola oil. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... A vasoconstrictor, also vasopressor or simply pressor, is any substance that acts to cause vasoconstriction (narrowing of the lumena of blood vessels) and usually results in an increase of the blood pressure. ... Dietary sources of omega-6 fatty acids include: cereals whole-grain breads margarine most vegetable oils eggs and poultry baked goods. ... Look up cell membrane in Wiktionary, the free dictionary. ... This article does not cite any references or sources. ...

Oral intake of magnesium has also been indicated in providing relief: two double-blind, placebo-controlled studies demonstrated a positive therapeutic effect of magnesium on dysmenorrhea.^[9][10] A randomized, double-blind, controlled trial demonstrated that oral intake of vitamin E relieves the pain of primary dysmenorrhea and reduces blood loss.^[11] A review of case histories indicated that zinc, in 1 to 3 30-milligram doses given daily for one to four days prior to onset of menses, prevents essentially all to all warning of menses and all menstrual cramping.^[12] Intake of thiamine (vitamin B₁) was demonstrated to provide "curative" relief in 87% of females experiencing dysmenorrhea, in a controlled study.^[13] Magnesium ions (Mg2+) in cellular biology are usually in almost all senses opposite to Ca2+ ions, because they are bivalent too, but have larger atomic radius. ... The double blind is ray charles is ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesof the scientific method, used to prevent research... For other uses, see Placebo (disambiguation). ... Tocopherol, or Vitamin E, is a fat-soluble vitamin in eight forms that is an important antioxidant. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ... The milligram (symbol mg) is an SI unit of mass. ... For the similarly spelled nucleic acid, see Thymine Thiamine or thiamin, also known as vitamin B1, is one of the B vitamins. ...

NSAIDs

Drugs which inhibit the production of prostaglandins, such as the non-steroidal anti-inflammatory drugs (NSAIDs) naproxen, ibuprofen and mefenamic acid can provide relief for the pain associated with high prostaglandin release.^{[citation needed]} NSAIDs are effective in relieving the pain of primary dysmenorrhea.^[14] NSAIDs can have side effects of nausea, dyspepsia, peptic ulcer, and diarrhea.^[15] Patients who cannot take the more common NSAIDs, or for whom they are not effective, may be prescribed a COX-2 inhibitor.^[16] One study indicated that conventional therapy with NSAIDs "provides symptomatic relief but has increasing adverse effects with long-term use",^[17] another indicated that long-term use of NSAIDs has "severe adverse effects".^[18] Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Naproxen (INN) (IPA: ) is a non-steroidal anti-inflammatory drug (NSAID) commonly used for the reduction of mild to moderate pain, fever, inflammation and stiffness caused by conditions such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, injury (like fractures), menstrual cramps, tendonitis, bursitis, and the treatment of primary... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks, including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Burana (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom... Mefenamic acid is a non-steroidal anti-inflammatory drug used to treat pain, including menstrual pain. ... Side-effect can mean: Side-effect (computer science), a state change caused by a function call Adverse drug reaction, an unintended consequence specifically arising from drug therapy Therapeutic effect (medicine), a desirable consequence of any kind of medical treatment, even though resulting as an unintended, unexpected consequence of the treatment... For other uses, see Nausea (disambiguation). ... A benign gastric ulcer (from the antrum) of a gastrectomy specimen. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... COX-2 selective inhibitor is a form of Non-steroidal anti-inflammatory drug (NSAID) that directly targets COX-2, an enzyme responsible for inflammation and pain. ...

Hormonal contraceptives

Oral contraceptives can improve or relieve symptoms of primary dysmenorrhea.^{[citation needed]} The mechanism of action involves reducing menstrual blood volume, and suppressing ovulation.^{[citation needed]} It may take up to three months of treatment to experience relief.^{[citation needed]} Norplant and Depo-provera are also effective, since these methods often induce amenorrhea.^{[citation needed]} The IntraUterine System (Mirena IUD) has been cited as useful in reducing symptoms of dysmenorrhea.^[19] Oral contraceptives are medications taken by mouth for the purpose of birth control. ... Ovulation is the process in the menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum (also known as an oocyte, female gamete, or casually, an egg) that participates in reproduction. ... Norplant is a form of birth control released in 1991 by Wyeth Pharmaceuticals, consisting of a set of six small, silicone capsules filled with levonorgestrel, a synthetic progestin used in many birth control pills. ... This article is about the contraceptive injection. ... Amenorrhoea (BE) or amenorrhea (AmE) is the absence of a menstrual period in a woman of reproductive age. ... The IntraUterine System or IUS is an IntraUterine Device (IUD or coil) that has a coating of levonorgestrel (a progesterone) on its shaft, rather than the traditional copper wire. ...

Non-drug therapies

Several non-drug therapies for dysmenorrhea have been indicated in studies, including acupuncture, acupressure, chiropractic care, and the use of a TENS unit.

Acupuncture and acupressure are used to treat dysmenorrhea. A review cited four studies, two of which were patient-blind, indicating that acupuncture and acupressure were effective.^[20] This review stated that the treatments appear "promising" for dysmenorrhoea, and that the researchers considered further studies to be justified. Another study indicated that acupuncture "reduced the subjective perception of dysmenorrhea",^[21] still another indicated that adding acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life.^[22] Acupuncture chart from Hua Shou (fl. ... Acupressure (a portmanteau of acupuncture and pressure) is a traditional Chinese medicine (TCM) technique based on the same ideas as acupuncture. ... For the communication paradox, see double bind. ... Acupressure (a portmanteau of acupuncture and pressure) is a traditional Chinese medicine (TCM) technique based on the same ideas as acupuncture. ...

Chiropractic care is disputed in its effectiveness. Some studies indicate its effectiveness, and claim that treating subluxations in the spine may cause the nerves leaving the spine to be less aggravated and so decrease symptoms, as well as other symptoms such as chronic stomach aches and headaches.^[23] Other research concluded that spinal manipulation is not an effective treatment.^[24]

Treatment with a transcutaneous electrical nerve stimulation (TENS) unit, often used for chronic pain, was indicated as effective in several studies.^{[25][26][27][28]} One study encouraged providers to try the TENS unit with patients, on the grounds that they found it to be "non-invasive, efficient, and easy to use".^[29] A study led by the same researchers reported proof of TENS' effectiveness.^[30] TENS (Transcutaneous Electrical Nerve Stimulator) is considered a method of pain relief, and has a wide following for use in obstetric care particularly labour. ...

Other medications and herbal therapies

Other medications and herbal therapies have been studied in the treatment of dysmenorrhea. One study indicated that two Japanese herbal medicines provided all of the study participants with complete relief.^[31] A review indicated the effectiveness of use of transdermal nitroglycerin.^[32] A double-blind, controlled study indicated that treatment with an extract of guava leaf resulted in significant reduction of symptoms.^[33] In a small double-blind, placebo-controlled study, guaifenesin reduced primary dysmenorrhea, but the effect was not significant.^[34] The term Herbalism refers to folk and traditional medicinal practice based on the use of plants and plant extracts. ... A transdermal patch is a medicated adhesive patch that is placed on the skin to deliver a time released dose of medication through the skin and into the bloodstream. ... Nitroglycerin (NG), also known as nitroglycerine, trinitroglycerin, and glyceryl trinitrate, is a chemical compound. ... The double blind is ray charles is ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesis ray charlesof the scientific method, used to prevent research... For other uses, see Placebo (disambiguation). ... Guaifenesin (IPA: ) (INN) or guaiphenesin (former BAN) is an expectorant drug usually taken orally to assist the expectoration (bringing up) of phlegm from the airways in acute respiratory tract infections. ...

Hormonal treatments

Hormonal treatments such as danazol, progestational agents, GnRH agonists, and progestins may be used.^{[citation needed]} One study suggested that vasopressin antagonists with V1(a) selectivity might be useful in treating a variety of disorders, including dysmenorrhoea.^[35] Danazol is a derivative of the synthetic steroid ethisterone, a modified testosterone. ... An antiandrogen, or androgen antagonist, is any of a group of hormone antagonist compounds that are capable of preventing or inhibiting the biologic effects of androgens, male sex hormones, on normally responsive tissues in the body (see androgen insensitivity syndrome). ... A gonadotropin-releasing hormone agonist (GnRH agonist) is a synthetic peptide modeled after the hypothalamic neurohormone GnRH that interacts with its receptor to elicit its biologic response, the release of the pituitary hormones FSH and LH. Agonists do not quickly dissociate from the GnRH receptor. ... Progestagens (also spelled progestogens or gestagens) are hormones similar in effect to progesterone, the only natural progestagen. ...

Surgical treatments

In severe cases, interruption of uterine nerves by presacral neurectomy and division of the sacrouterine ligaments may be used when other treatment options fail.^{[citation needed]} For other uses, see Nerve (disambiguation). ... In human anatomy, the presacral space is behind the rectum and in front of the coccyx. ... Neurectomy is the surgical removal of a nerve or a section of a nerve. ... In anatomy, the term ligament is used to denote three different types of structures:[1] Fibrous tissue that connects bones to other bones. ...

Prognosis

A survey in Norway showed that 14 percent of females between the ages of 20 to 35 experience symptoms so severe that they stay home from school or work.^[36] Among adolescent girls, dysmenorrhea is the leading cause of recurrent short-term school absence in this group.^[37]

Epidemiology

Reports of dysmenorrhea are greatest among individuals in their late teens and 20s, with reports usually declining with age. One study indicated that 67.2% of adolescent girls experienced dysmenorrhea.^[38] Another study indicated that dysmenorrhoea was present in 36.4% of participants, and was significantly associated with lower age and lower parity.^[39] Childbearing can relieve dysmenorrhea.^[40] One study indicated that in nulliparous women with primary dysmenorrhea, the severity of menstrual pain decreased significantly after age 40.^[40] In medicine, parity is a technical term that refers to the number of times a woman has given birth. ... In medicine, parity is a technical term that refers to the number of times a woman has given birth. ...

Secondary dysmenorrhea

Signs and symptoms

The symptoms of secondary dysmenorrhea vary with the underlying cause, but generally the pain associated with secondary dysmenorrhea is not limited to the time around menses, as with primary dysmenorrhea.^{[citation needed]}

Etiology

The most common cause of secondary dysmenorrhea is endometriosis.^[37] Approximately 24% of females who report pelvic pain are subsequently found to have endometriosis.^{[citation needed]} Other causes include pelvic inflammatory disease,^{[citation needed]} leiomyoma,^[41] adenomyosis,^[42] ovarian cysts, and pelvic congestions.^[43] The presence of a copper IUD can also cause dysmenorrhea.^[44][45] Some find that use of internally-worn menstrual products (such as tampons and menstrual cups) exacerbate dysmenorrhea.^{[citation needed]} Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ... A leiomyoma (plural is leiomyomata) is a benign smooth muscle neoplasm that is not premalignant. ... Adenomyosis is a medical condition characterized by the presence of ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus). ... An intrauterine device (intra meaning within, and uterine meaning of the uterus) is a birth control device also known as an IUD or a coil( this colloquialism is based on the coil-shaped design of early IUDs). ... A tampon with an applicator. ... A menstrual cup is a type of cup or barrier worn by a female inside the vagina during menstruation to collect menstrual fluid. ...

Pathophysiology

The mechanisms causing the pain of secondary dysmenorrhea are varied, and may or may not involve prostaglandins.^{[citation needed]} Secondary dysmenorrhea is less related to the onset of bleeding in menstruation, is seen in older females, and is sometimes associated with other conditions, such as infertility.^{[citation needed]} Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. ...

Treatment

Of underlying causes

The most effective treatment of secondary dysmenorrhea is the identification and treatment of the underlying cause of the pain.^{[citation needed]} The first line of treatment is medical; if possible, the underlying medical disorder or anatomic abnormality is corrected.^{[citation needed]} Dilation of a narrow cervical os may give 3 to 6 months of relief, and allows diagnostic curettage if needed.^{[citation needed]} Myomectomy, polypectomy, or dilation and curettage may be needed.^{[citation needed]} In patients with adenomyosis, the levonorgestrel intrauterine system (Mirena) was observed to provide relief.^[46] The external orifice of the uterus (or ostium of uterus, or external os) is a small, depressed, somewhat circular aperture on the rounded extremity of the vaginal portion of the cervix. ... In surgery, the use of a curette to remove tissue by scraping or scooping. ... Myomectomy refers to the surgical removal of uterine fibroids. ... Polypectomy is the removal of a polyp through coloscopy or endoscopy. ... Dilation (dilatation) and curettage literally refers to the dilation (opening) of the cervix and surgical removal of the contents of the uterus. ... Levonorgestrel (or l-norgestrel or D-norgestrel) is a synthetic progestogen used as an active ingredient in some hormonal contraceptives. ... The IntraUterine System or IUS is an IntraUterine Device (IUD or coil) that has a coating of levonorgestrel (a progesterone) on its shaft, rather than the traditional copper wire. ...

Pain relief

The medical options used for relieving pain in secondary dysmenorrhea are similar to those used in primary dysmenorrhea.^{[citation needed]}

References

Medline is a comprehensive literature database of life sciences and biomedical information. ... Medline is a comprehensive literature database of life sciences and biomedical information. ... Medline is a comprehensive literature database of life sciences and biomedical information. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... The Australian Medicines Handbook or AMH is a medical reference text commonly used in practice by health professionals (particularly general practitioners and pharmacists) in Australia. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... is the 298th day of the year (299th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 33rd day of the year in the Gregorian calendar. ...

External links

Dysmenorrhea at the Open Directory Project The Open Directory Project (ODP), also known as dmoz (from , its original domain name), is a multilingual open content directory of World Wide Web links owned by Netscape that is constructed and maintained by a community of volunteer editors. ...