Dysmenorrhea_DCAB.pptx

PRIMARY and SECONDARY Dysmenorrhea Denice Cloe A. Bartolome, M.D.  CONTENTS Symptoms Pathogenes is Treatment PATHOGEN ESIS SECONDARY DYSMENORRHEA SYMPTO MS  CERVICAL STENOSIS Severe narrowing of the cervical canal...

PRIMARY and SECONDARY Dysmenorrhea Denice Cloe A. Bartolome, M.D.  CONTENTS Symptoms Pathogenes is Treatment PATHOGEN ESIS SECONDARY DYSMENORRHEA SYMPTO MS  CERVICAL STENOSIS Severe narrowing of the cervical canal Congenital, secondary to cervical injury, or inflammatory process Cervical stenosis ssssx impede mens inc. uterine retrograde mens pressure endometriosis CERVICAL STENOSIS Diagnosis: external os appears scarred impossible to pass a cervical Pap smear brush or uterine Treatment: Dilatation and Curettage vaginal delivery Ectopic Endometrial Tissue: ENDOMETRIOSIS endometrial glands and stroma outside of the uterus affects 6% to 10% of reproductive age women 70% to 80% with chronic pelvic pain Ectopic Endometrial Tissue: ADENOMYOSIS endometrial glands and stroma in the myometrium  PELVIC INFLAMMATION gonorrhea, chlamydia, or other microbes can lead to chronic pelvic pain in up to 30% of women PELVIC CONGESTION SYNDROME AND PELVIC VENOUS SYNDROMES engorgement of pelvic vasculature chronic pelvic discomfort worsened by prolonged standing and intercourse  DIAGNO SIS History Physical Exam Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014 Mar 1;89(5):341-6.  TREATMENT PHARMACOLOG NON IC PHARMACOLOGIC Exercise NSAIDs Heat OCPs Behavioral Tocolytics Int. Diet PREMENSTRUAL Syndrome and DYSPHORIC Disorder PREMENSTRUAL SYNDROME 3% - 8% clinically relevant family history personal past or current psychiatric illness history of alcohol abuse history of postpartum depression PREMENSTRUAL DYSPHORIC DISORDER 2% suffers associated with lower education, major depression, smoking TREATME NT Diet, Supplements, Exercise, Lifestyle Changes increasing complex carbohydrate intake Vitamin B6 supplement regular exercise massage, biofeedback, yoga, acupuncture enough sleep PSYCHOACTIVE DRUGS: SSRI first-line treatment rapid onset of action effective in approximately 60% 5% of women on SSRIs have significant side effects Increased suicide rates Quetiapine = adjunct  OCPs NSAIDs help physical for systemic symptoms symptoms reasonable first toxicity: nonoliguric therapy renal failure OTHER TREATMENTS DIURETICS BROMOCRIPTINE GnRH AGONISTS SURGERY  Thank You!! CREDITS: This presentation template was created by Slidesgo, and includes icons by Flaticon, and infographics & images by Freepik