Dysmenorrhea in adolescents and young adults: An update on pharmacological treatments and management strategies
Dysmenorrhea is the most common gynecologic complaint among adolescents/young adults. Dysmenorrhea is usually primary and is associated with normal ovulatory cycles and with no pelvic pathology. Potent prostaglandins and potent leukotrienes play an important role in generating primary dysmenorrhea symptoms. Adolescents/young adults with severe dysmenorrhea symptoms may have pelvic abnormalities, such as endometriosis or uterine anomalies (secondary dysmenorrhea).
This review provides an update on treatments and management strategies of dysmenorrhea in adolescents/young adults. Medical literature articles were retrieved using a Medline search on primary and secondary dysmenorrhea. Original articles from peer-reviewed journals were selected based on relevance.
Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) is the preferred initial treatment for dysmenorrhea in nonsexually active adolescents/young adults. Adolescents/young adults with symptoms that do not respond to NSAIDs for three menstrual periods should be offered hormonal treatment, such as combined estrogen and progestin oral contraceptive pills (OCPs), for three menstrual cycles. If dysmenorrhea does not improve within 6 months of NSAIDs and OCPs, a laparoscopy is indicated to look for endometriosis, which is the most common reason for secondary dysmenorrhea.
- SourceAvailable from: Farzaneh Kashefi
[Show abstract] [Hide abstract]
- "Dysmenorrhea has been shown to be one of the most common gynecological complaints of young women and may result in short - term absence from school or work ( Parker , Sneddon , & Arbon , 2010 ) . Research has shown that menstrual pain in young women is usu - ally primary and is accompanied by normal ovulatory cycles with no pathological background ( Harel , 2012 ) . Although some individuals may prefer to treat their menstrual pain with chemical medications ( Parker et al . "
ABSTRACT: Dear Author, Please check your proof carefully and mark all corrections at the appropriate place in the proof (e.g., by using on-screen annotation in the PDF file) or compile them in a separate list. Note: if you opt to annotate the file with software other than Adobe Reader then please also highlight the appropriate place in the PDF file. To ensure fast publication of your paper please return your corrections within 48 hours. For correction or revision of any artwork, please consult Any queries or remarks that have arisen during the processing of your manuscript are listed below and highlighted by flags in the proof. Location in article Query / Remark: Click on the Q link to find the query's location in text Please insert your reply or correction at the corresponding line in the proof If there are any drug dosages in your article, please verify them and indicate that you have done so by initialing this query Q1 Please provide degrees for author Javad Asili and confirm all author degrees and affiliations. Q2 Minor syntax adjustments were made throughout. Please read carefully to ensure that intended meaning was retained. Please note also that the format of the abstract has been changed to unstructured in accordance with journal guidelines. Q3 Ok to change in to by the faculty of pharmacy Q4 Please check the mailing address is correct as provided. Q5 Please confirm that given names and surnames have been identified correctly. Please check this box or indicate your approval if you have no corrections to make to the PDF file , Thank you for your assistance.
- [Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND Endometriosis associated with pain symptoms in adolescents has been extensively reported, but the exact prevalence is unclear because pain symptoms may be atypical and endometriosis can only be diagnosed by laparoscopy. The aim of this paper is to provide a systematic review of the prevalence of endometriosis diagnosed by laparoscopy in adolescents.METHODSA systematic literature search was carried out for relevant articles published between 1980 and 2011 in the databases PUBMED and EMBASE, based on the keywords 'endometriosis', 'laparoscopy', 'adolescents' and 'chronic pelvic pain (CPP)'. In addition, the reference lists of the selected articles were examined.RESULTSBased on 15 selected studies, the overall prevalence of visually confirmed endometriosis was 62% (543/880; range 25-100%) in all adolescent girls undergoing laparoscopic investigation, 75% (237/314) in girls with CPP resistant to treatment, 70% (102/146) in girls with dysmenorrhea and 49% (204/420) in girls with CPP that is not necessarily resistant to treatment. Among the adolescent girls with endometriosis, the overall prevalence of American Society of Reproductive Medicine classified moderate-severe endometriosis was 32% (82/259) in all girls, 16% (17/108) in girls with CPP resistant to treatment, 29% (21/74) in girls with dysmenorrhea and 57% (44/77) in girls with CPP that is not necessarily resistant to treatment. Due to the quality of the included papers an overestimation of the prevalence and/or severity of endometriosis is possible.CONCLUSIONS About two-thirds of adolescent girls with CPP or dysmenorrhea have laparoscopic evidence of endometriosis. About one-third of these adolescents with endometriosis have moderate-severe disease. The value of early detection of endometriosis in symptomatic adolescents and the indications for laparoscopic investigation in adolescents require more research.Human Reproduction Update 05/2013; 19(5). DOI:10.1093/humupd/dmt016 · 10.17 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Growth disorders and endocrine complications in thalassaemia 1st part