DYSMENORRHEA

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DYSMENORRHEA

• Ozgul Muneyyirci-Delale

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DYSMENORRHEA

• Primary
• Secondary

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CAUSES OF SECONDARY DYSMENORRHEA

• Tissue or Organ System Pathology
• Peritoneum Endometriosis
• Allen-Masters syndrome
• Pelvic congestion syndrome
• Ovary Ovarian cysts or tumor
• Fallopian Tubes Pelvic inflammatory disease
• (acute and chronic)
• Uterus Adenomyosis
• Uterine myomas
• Uterine polyps
• Intrauterine adhesions
• (Ashermans syndrome

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• Uterus Congenital malformations
• (bicornuate and septate uterus,
• blind uterine horn)
• IUD
• Cervix Stenosis
• Vagina Imperforate hymen
• Transverse vaginal septum

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COMPOUNDS THAT INHIBIT PROSTAGLANDIN FORMATION

• (In decreasing order of potency)
• Meclofenamic acidgtniflumic acid
• Indomethacingtmefenamic acidgt
• Flufenamic acidgtnaproxengt
• Phenylbutazonegtaspirin or ibuprofen

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DYSMENORRHEA

• A favorable response to placebo was observed in
  84 in the first cycle, 21 in the second, 16 in
  the third, and 10 in the fourth (Fedele L et al,
  1989).

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OTHER TREATMENT MODALITIES FOR DYSMENORRHEA

• Transcutaneous electrical nerve stimulation
• Terbutaline inhalation
• Levonorgestrel-releasing intrauterine device
• Vasopressin antagonist
• Vasopressin VI receptor antagonist
• Transdermal nitroglycerine
• Acupuncture
• Herbal medicine (shakuyaku-kanzo-to)
• Cyclooxygenase-2 inhibitor
• Leukotriene receptor antagonist

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TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS)

• TENS relieves primary dysmenorrhea through two
  mechanisms
• 1. The pregangionic fibers are bombarded with
  impulses that saturate the nerve cells of the
  dorsal horn (the gate control theory).
• 2. TENS induces the release of endorphins from
  these nerve cells.