Dysmenorrhea Overview and Treatment

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Questions and Answers

What is a characteristic of Primary Dysmenorrhea?

Does not respond to NSAIDs

Onset with beginning of menses and lasts 2-3 days (correct)

Is irregular and may include intermenstrual bleeding

Occurs at least 2 years after the first period

Which of the following treatments is considered the best choice for Primary Dysmenorrhea?

Aspirin

Diuretics

Acetaminophen

NSAIDs (correct)

What is a typical symptom of Secondary Dysmenorrhea?

Fatigue

Headache

Intermenstrual bleeding (correct)

Regular menstrual cycles

What defines Premenstrual Dysphoric Disorder?

5 or more symptoms, including mood symptoms, resolving after the period Signup and view all the answers

Which of the following is NOT a positive symptom of Premenstrual Syndrome?

Feeling stressed Signup and view all the answers

What role does Pyridoxine play in the treatment of premenstrual symptoms?

It is a dietary supplement for mood regulation Signup and view all the answers

What is the function of diuretics in the context of premenstrual symptoms?

To reduce bloating Signup and view all the answers

Which of the following is true regarding the symptoms of Secondary Dysmenorrhea?

They may vary but can include pelvic tenderness Signup and view all the answers

What timeframe is typical for the onset of Primary Dysmenorrhea after the first menstrual period?

6-12 months to several years afterwards Signup and view all the answers

Which of the following statements correctly differentiates between Primary and Secondary Dysmenorrhea?

Secondary Dysmenorrhea typically arises at least 2 years after the first period. Signup and view all the answers

What is a noted effect of NSAIDs on Primary Dysmenorrhea?

They provide relief from symptoms for 2-3 days. Signup and view all the answers

Which of the following is a treatment specifically recommended for bloating during premenstrual symptoms?

Diuretics Signup and view all the answers

What characterizes Premenstrual Exacerbation?

No symptom-free interval occurs Signup and view all the answers

Which symptom is NOT commonly associated with Premenstrual Syndrome?

Dysmenorrhea Signup and view all the answers

How do symptoms of Secondary Dysmenorrhea typically differ from Primary Dysmenorrhea?

They are more likely to be irregular and can include intermenstrual bleeding. Signup and view all the answers

What is a common positive symptom observed during Premenstrual Syndrome?

Increased libido Signup and view all the answers

Which of the following OTC treatments is advised for alleviating pain associated with premenstrual symptoms?

NSAIDs Signup and view all the answers

What symptom is characteristic of bacterial vaginosis?

Yellow/green discharge with a fishy odor Signup and view all the answers

Which OTC treatment is used specifically for yeast infections?

Clotrimazole Signup and view all the answers

What is a common characteristic of atrophic vaginitis?

Thinning and dryness of the vaginal walls Signup and view all the answers

Which of the following is NOT a typical treatment for bacterial vaginosis?

Over-the-counter antifungals Signup and view all the answers

For trichomoniasis, which symptom is commonly observed?

Yellow/green discharge with a foul odor Signup and view all the answers

What is the primary active ingredient in Vagisil?

Benzocaine Signup and view all the answers

Which OTC option is recommended for vulvovaginal candidiasis?

Miconazole Nitrate Signup and view all the answers

Which home treatment is effective for non-C. Albicans infections?

Boric acid Signup and view all the answers

What is the main reason vaginal antifungals are recommended to be used at night?

So they remain in place while lying down Signup and view all the answers

Study Notes

Dysmenorrhea

Primary Dysmenorrhea:
- Occurs 6-12 months after first period, but often years later
- Regular menstrual cycles with normal blood loss
- Onset with menstruation, lasting 2-3 days
- Responds to NSAIDs
- Other symptoms: headache, fatigue, nausea, appetite changes, backache, dizziness
Treatment for Primary Dysmenorrhea (OTC):
- Aspirin, acetaminophen, and NSAIDs (best choice)
- NSAIDs: Ibuprofen (200-400 mg every 4-6 hours), Naproxen (220-440 mg initially, then 220 mg every 8-12 hours)
- Aspirin: 650-1000 mg every 4-6 hours
- Acetaminophen: 650-1000 mg every 4-6 hours
- Selenium
Secondary Dysmenorrhea:
- Occurs at least 2 years after first period, typically mid-to-late 20s or later
- Irregular cycles with intermenstrual bleeding
- Pattern and duration vary
- Can occur before, during, or after menses
- NSAIDs are often not sufficient
- Other symptoms include dyspareunia or pelvic tenderness

Exclusions for Self-Treatment

Severe dysmenorrhea and/or menorrhagia
Symptoms inconsistent with primary dysmenorrhea (e.g., unusual age at onset, pain at times other than menses)
History of PID, infertility, irregular cycles, endometriosis, or ovarian cysts
Use of intrauterine device (IUD)
Aspirin or NSAID allergy/intolerance
Use of warfarin, heparin, or lithium
Active GI disease (PUD, GERD, ulcerative colitis)
Bleeding disorder

Treatment Options

Nonpharmacologic:
- Sleep, hot baths, exercise
- Discontinue tobacco use

OTC Drug Therapy with NSAIDs

Initiate at onset of menses or symptoms
Continue for several days
Scheduled doses

Premenstrual Syndrome (PMS)

At least one mood or physical symptom during 5 days prior to menses
Premenstrual dysphoric disorder (PMDD): 5+ symptoms, one being mood, and mood symptoms gone a week after period
Premenstrual exacerbation: worsening of psychotic symptoms (e.g., IBS, asthma) that worsen premenstrually

Premenstrual Symptoms

Negative symptoms: fatigue, lack of energy, irritability, anger, mood swings, depression, anxiety, stress, crying, oversensitivity, difficulty concentrating, abdominal bloating, edema, breast tenderness, appetite changes, headaches, hypersomnia, insomnia, joint/muscle pain
Positive symptoms: increased energy, work efficiency, increased libido, affection, sense of control, self-assurance

OTC Medications for PMS

Pyridoxine (Vitamin B6)
Calcium and Vitamin D
Magnesium
NSAIDs (for pain)
Diuretics (for bloating)
Combination therapy is a common treatment approach

Additional Notes

Self-treat with care
- Do not self-treat with NSAIDs if there are contraindications
- Do not give NSAIDs if there is a sensitivity or allergy.
Consult physician
- Re-evaluate if symptoms persist, worsen, or if response to therapy changes
- Refer to a healthcare professional if symptoms are worse or response to treatment is inadequate.
Patient education
- Lifestyle modifications are helpful.

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Description

Explore the types of dysmenorrhea, including primary and secondary forms, and their distinct characteristics. Learn about the symptoms, onset, and recommended over-the-counter treatments for managing pain. This quiz provides valuable insights into menstrual health and management.