Materiały źródłowe

• #1 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. […] Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. […] See your health care provider if: Menstrual cramps disrupt your life every month. […] Menstrual cramps can be caused by: Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis. […] Menstrual cramps don’t cause other medical complications, but they can interfere with school, work and social activities.

• #2 Dysmenorrhea: Menstrual Cramps, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea

  Dysmenorrhea is the medical term for painful menstrual periods. It happens because your uterus contracts to shed its lining. The pain typically begins just before your period and subsides after a few days. Primary dysmenorrhea refers to recurrent pain with no identifiable cause. Secondary dysmenorrhea results from conditions like endometriosis. […] Dysmenorrhea is the medical term for painful periods (menstruation) or menstrual cramps. In addition to cramping, you might have other symptoms, such as nausea, fatigue and diarrhea. Its most common to have menstrual cramps the day before or the day you start your period. For most people, symptoms subside after about two or three days. […] Mild to moderate menstrual cramping is normal. But some people have such severe pain during their period that it interferes with their day-to-day life and prevents them from doing things they enjoy. Medication and other treatments can help with painful periods.

• #3 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients’ quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primary dysmenorrhea is menstrual pain in the absence of pelvic pathology. Abnormal uterine bleeding, dyspareunia, noncyclic pain, changes in intensity and duration of pain, and abnormal pelvic examination findings suggest underlying pathology (secondary dysmenorrhea) and require further investigation. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Dysmenorrhea is considered primary in the absence of underlying pathology. Onset is typically six to 12 months after menarche, with peak prevalence occurring in the late teens or early twenties. Secondary dysmenorrhea results from specific pelvic pathology. It should be suspected in older women with no history of dysmenorrhea until proven otherwise. Symptoms include menorrhagia, intermenstrual bleeding, dyspareunia, postcoital bleeding, and infertility.

• #4 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Dysmenorrhea is defined as pain during the menstrual cycle. The pain is usually located in the lower abdomen and may radiate to the inner thighs and back. […] This activity reviews the evaluation and management of dysmenorrhea or painful menstruation. It highlights the role of the interprofessional team in evaluating and treating patients with dysmenorrhea, as well as appropriately referring to subspecialty care when indicated. […] Dysmenorrhea can be classified as primary or secondary. Primary dysmenorrhea is recurrent lower abdominal pain that happens during the menstrual cycle and is not associated with other diseases or underlying pathology. […] In contrast, secondary dysmenorrhea is associated with suspected or clinically identifiable pathology. […] A comprehensive history, along with an adequate physical examination, is essential to establish the diagnosis of dysmenorrhea. A history, including the location of pain, timing of onset, characteristics, duration, and associated symptoms like fatigue, headache, diarrhea, nausea, and vomiting, can help establish a diagnosis. […] In patients with primary dysmenorrhea, the physical examination findings are usually unremarkable.

• #5 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients’ quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primary dysmenorrhea is menstrual pain in the absence of pelvic pathology. Abnormal uterine bleeding, dyspareunia, noncyclic pain, changes in intensity and duration of pain, and abnormal pelvic examination findings suggest underlying pathology (secondary dysmenorrhea) and require further investigation. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Dysmenorrhea is considered primary in the absence of underlying pathology. Onset is typically six to 12 months after menarche, with peak prevalence occurring in the late teens or early twenties. Secondary dysmenorrhea results from specific pelvic pathology. It should be suspected in older women with no history of dysmenorrhea until proven otherwise. Symptoms include menorrhagia, intermenstrual bleeding, dyspareunia, postcoital bleeding, and infertility.

• #6 Dysmenorrhea: Menstrual Cramps, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea

  Primary dysmenorrhea is the name for menstrual cramps that come back every time you have get period, but arent due to another medical condition. Pain usually begins one or two days before you get your period or when the bleeding actually starts. […] If you have painful periods because of a condition or an infection in your reproductive organs, its secondary dysmenorrhea. Pain from secondary dysmenorrhea usually begins earlier in your menstrual cycle and lasts longer than typical menstrual cramps. […] Its normal to have some pain during menstruation. About 60% of people with a uterus have mild cramps during their period. About 5% to 15% of people report period pain thats so severe that it affects their daily activities. […] Menstrual cramps happen when a chemical called prostaglandin makes your uterus contract (tighten up).

• #7 Dysmenorrhea: Menstrual Cramps, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea

  Primary dysmenorrhea is the name for menstrual cramps that come back every time you have get period, but arent due to another medical condition. Pain usually begins one or two days before you get your period or when the bleeding actually starts. […] If you have painful periods because of a condition or an infection in your reproductive organs, its secondary dysmenorrhea. Pain from secondary dysmenorrhea usually begins earlier in your menstrual cycle and lasts longer than typical menstrual cramps. […] Its normal to have some pain during menstruation. About 60% of people with a uterus have mild cramps during their period. About 5% to 15% of people report period pain thats so severe that it affects their daily activities. […] Menstrual cramps happen when a chemical called prostaglandin makes your uterus contract (tighten up).

• #8 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8943241/

  Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. […] While its diagnosis is based on patients history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). […] The diagnosis of PD is made mainly by retrieving a focused medical history and performing a physical examination to exclude the presence of pelvic pathology. […] Since females with typical symptoms of PD can be diagnosed solely on the basis of their medical information, without any physical or pelvic examination, empiric treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs) and/or oral contraceptives should be initiated.

• #9 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your provider checks for anything unusual with the reproductive organs and looks for signs of infection. […] Your provider may also recommend certain tests, including: […] Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries. […] Other imaging tests. A computed tomography (CT) scan or Magnetic resonance imaging (MRI) scan provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. […] Laparoscopy. Although not usually necessary to diagnosis menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.

• #10 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

• #11 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  For menstrual cramps, basic questions include: […] Do I need any tests done? […] Your doctor is likely to ask you questions, such as: […] Do your symptoms cause you to limit your activities, stay home from work or school, or avoid exercise? […] What treatments have you tried so far, if any? Has anything helped?

• #12 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Dysmenorrhea is defined as pain during the menstrual cycle. The pain is usually located in the lower abdomen and may radiate to the inner thighs and back. […] This activity reviews the evaluation and management of dysmenorrhea or painful menstruation. It highlights the role of the interprofessional team in evaluating and treating patients with dysmenorrhea, as well as appropriately referring to subspecialty care when indicated. […] Dysmenorrhea can be classified as primary or secondary. Primary dysmenorrhea is recurrent lower abdominal pain that happens during the menstrual cycle and is not associated with other diseases or underlying pathology. […] In contrast, secondary dysmenorrhea is associated with suspected or clinically identifiable pathology. […] A comprehensive history, along with an adequate physical examination, is essential to establish the diagnosis of dysmenorrhea. A history, including the location of pain, timing of onset, characteristics, duration, and associated symptoms like fatigue, headache, diarrhea, nausea, and vomiting, can help establish a diagnosis. […] In patients with primary dysmenorrhea, the physical examination findings are usually unremarkable.

• #13 Period Cramps? Free 3-Min Quiz Identifies Causes | Ubie

  https://ubiehealth.com/symptoms/menstrual-pain

  Your doctor may ask these questions to check for this symptom: Are you experiencing menstrual cramps? When did you first start experiencing menstrual cramps? How frequently do you experience severe menstrual cramps? How would you describe the severity of your menstrual cramps or discomfort? How are your menstrual cramps now?

• #14 Cramps but No Period: Causes and Diagnosis

  https://www.webmd.com/women/cramps-but-no-period

  Cramps but No Periods: Diagnosis […] Always call a doctor if you have cramps that wont go away, whether or not you have your period. (Get medical help right away if you have sudden, severe belly pain that continues to get worse.) […] Your doctor will want to know if your pain is sudden or ongoing. The more details you can give, the faster they may be able to diagnose and treat you. Youll be asked questions about your symptoms and your periods. […] Your doctor may do tests or procedures to learn the cause of your cramps. If your doctor suspects it is related to your uterus, or ovaries, common tests are: […] Pelvic exam […] Ultrasound […] Laparoscopy, a type of exploratory surgery to look at the structures inside your pelvic area, including your uterus, cervix, ovaries, and fallopian tubes

• #15 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Primary dysmenorrhea may be diagnosed based on the typical history alone. Pain begins just before or at the start of menstrual bleeding. It is cyclic and begins with the onset of ovulatory cycles, usually within 2 years of menarche. […] A pelvic examination is important for evaluating dysmenorrhea if the history of onset and duration of lower abdominal pain suggests secondary dysmenorrhoea or if the dysmenorrhea is not responding to medical treatment. […] Treatment of dysmenorrhea is aimed at providing adequate pain relief to allow patients to perform most of their daily activities. Treatment for primary and secondary dysmenorrhea begins similarly. […] If symptoms do not respond to initial treatments, an evaluation for potential causes of secondary dysmenorrhea may be warranted. […] Common findings that may indicate secondary dysmenorrhea include older age versus younger age, vaginal discharge that is whitish gray, mucopurulent, or has a foul odor, and heavy menstrual bleeding with a mildly enlarged symmetrical uterus. […] The differential diagnosis of dysmenorrhea is broad. It can be categorized as gynecological conditions and non-gynecological conditions. […] The prognosis for primary dysmenorrhea is generally good. Mild and moderate dysmenorrhea usually responds well to NSAIDs. […] The prognosis of secondary dysmenorrhea depends on the etiology, type, location, and severity of the cause.

• #16 Menstrual Cramps (Dysmenorrhea) in Teens – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=menstrual-cramps-dysmenorrhea-in-teens-90-P01599

  Menstrual cramps are severe, painful cramps that occur during a period. […] Secondary menstrual cramps are often caused by endometriosis. […] The healthcare provider will ask about your child’s symptoms and health history. […] The provider will give your teen a physical exam. […] The physical exam may include a pelvic exam. […] Your daughter may also have tests, such as: Ultrasound. […] Laparoscopy. […] Hysteroscopy. […] Symptoms of secondary menstrual cramps can start several days before menstrual bleeding starts. […] Make sure your child sees her healthcare provider for a diagnosis. […] There are many treatment options. […] Painful periods can be hard to cope with every month. […] Call the healthcare provider if your child has: Symptoms that don’t get better, or get worse.

• #17 Menstrual disorders Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/menstrual-disorders

  Dysmenorrhea refers to painful cramps during menstruation. […] Dysmenorrhea is severe, frequent cramping during menstruation. Pain occurs in the lower abdomen but can spread to the lower back and thighs. […] Primary dysmenorrhea is caused by prostaglandins, hormone-like substances that are produced in the uterus and cause the uterine muscle to contract. […] Secondary dysmenorrhea can be caused by a number of medical conditions. Common causes of secondary dysmenorrhea include endometriosis and uterine fibroids. […] Your medical history can help a health care provider determine whether a menstrual problem is caused by another medical condition. […] A menstrual diary is a helpful way to keep track of changes in menstrual cycles. […] A pelvic exam is a standard part of diagnosis. […] Blood tests can help rule out other conditions that cause menstrual disorders.

• #18 PMS: Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellhealth.com/do-i-have-pms-3522569

  PMS is often diagnosed based on the timing of the symptoms. […] There are several screening tools used in the diagnosis of PMS. Generally, healthcare providers use a medical history or questionnaire to diagnose this condition. […] You probably have PMS if you have symptoms that: […] You can keep a calendar to help you keep track of the timing of your symptoms. […] The easiest way to determine if you have PMS is to keep track of your symptoms for two or three months on a standard calendar. […] You may need a diagnostic evaluation to search for hormonal or uterine problems if you have extreme physical symptoms and/or irregular bleeding. […] If your symptoms do not follow a cyclical pattern, your healthcare provider may consider other conditions such as depression, anxiety, gastrointestinal disease, or thyroid disease.

• #19 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your provider checks for anything unusual with the reproductive organs and looks for signs of infection. […] Your provider may also recommend certain tests, including: […] Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries. […] Other imaging tests. A computed tomography (CT) scan or Magnetic resonance imaging (MRI) scan provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. […] Laparoscopy. Although not usually necessary to diagnosis menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.

• #20 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

• #21 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html/1000

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] A pelvic examination should be performed in adolescents who have had vaginal intercourse because of the high risk of PID in this population. A pelvic examination is not essential for adolescents with symptoms of primary dysmenorrhea who have never had vaginal intercourse. However, if endometriosis is suspected, pelvic and rectovaginal examinations should be performed.

• #22 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  The pelvic exam should be normal in patients with primary dysmenorrhea when not menstruating. […] Transvaginal ultrasonography is the preferred method for the initial evaluation of pelvic organs. […] Although endometriosis is a common cause of secondary dysmenorrhea, routine pelvic ultrasound is frequently unremarkable in affected patients unless there is anatomic distortion, endometrioma, or evidence of deep infiltrative endometriosis. […] Delays in diagnosis and treatment are common and should be avoided. […] The goals of treatment are to provide satisfactory pain and symptom relief and reduce the disturbance in daily activities. […] Therapeutic options should take into account a patient’s contraceptive needs, as both nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives are considered first-line agents, either separately or in combination.

• #23 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html/1000

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] A pelvic examination should be performed in adolescents who have had vaginal intercourse because of the high risk of PID in this population. A pelvic examination is not essential for adolescents with symptoms of primary dysmenorrhea who have never had vaginal intercourse. However, if endometriosis is suspected, pelvic and rectovaginal examinations should be performed.

• #24 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

• #25 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html/1000

  Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected.

• #26 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your provider checks for anything unusual with the reproductive organs and looks for signs of infection. […] Your provider may also recommend certain tests, including: […] Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries. […] Other imaging tests. A computed tomography (CT) scan or Magnetic resonance imaging (MRI) scan provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. […] Laparoscopy. Although not usually necessary to diagnosis menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.

• #27 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

• #28 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

• #29 Exams and Tests Used to Investigate Menstrual Disorders – Your Period

  https://www.yourperiod.ca/abnormal-pain-and-menstrual-bleeding/exams-and-tests-used-to-investigate-menstrual-disorders/

  If you have abnormal menstrual bleeding, you may require testing in order to determine the underlying problem. […] If you are experiencing abnormal menstrual bleeding, your doctor will likely recommend that you undergo some testing. Blood and urine samples may be collected, and there are a number of ways that the inside of your pelvic organs can be visualized. […] This list of tests does not include blood tests that you might take, and is specifically referring to physical exam, imaging, radiology, and biopsies. […] A pelvic exam allows your doctor to examine your pelvic organs. […] A pelvic ultrasound is used to visualize the organs in the lower pelvis, including the uterus, cervix, fallopian tubes, ovaries, and bladder. […] Transvaginal ultrasound uses sound waves to provide images of the female reproductive organs, including the uterus, cervix, ovaries, fallopian tubes, and pelvic area.

• #30 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  The pelvic exam should be normal in patients with primary dysmenorrhea when not menstruating. […] Transvaginal ultrasonography is the preferred method for the initial evaluation of pelvic organs. […] Although endometriosis is a common cause of secondary dysmenorrhea, routine pelvic ultrasound is frequently unremarkable in affected patients unless there is anatomic distortion, endometrioma, or evidence of deep infiltrative endometriosis. […] Delays in diagnosis and treatment are common and should be avoided. […] The goals of treatment are to provide satisfactory pain and symptom relief and reduce the disturbance in daily activities. […] Therapeutic options should take into account a patient’s contraceptive needs, as both nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives are considered first-line agents, either separately or in combination.

• #31 Period Pain- Symptoms, Diagnosis, And Treatment | 24-7Medcare

  https://24-7medcare.com.au/pain/period-pain/

  Period pain is a common problem for individuals undergoing regular menstrual cycles. Many people who experience regular period pain should seek a consultation with a doctor to receive treatment and advice. […] It’s essential to consult your GP to determine what tests need to be performed to see what could be leading to your symptoms. To help with diagnosis, your GP may suggest the following tests: […] Your GP may require a pelvis and physical assessment depending on your circumstances. This may provide enough information to determine what type of tests and follow-ups may be necessary. […] Ultrasound imaging uses high-frequency sound waves to create a series of images inside the body. It is typically recommended to determine what conditions could be causing regular period pain, such as endometriosis and adenomyosis.

• #32 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  The pelvic exam should be normal in patients with primary dysmenorrhea when not menstruating. […] Transvaginal ultrasonography is the preferred method for the initial evaluation of pelvic organs. […] Although endometriosis is a common cause of secondary dysmenorrhea, routine pelvic ultrasound is frequently unremarkable in affected patients unless there is anatomic distortion, endometrioma, or evidence of deep infiltrative endometriosis. […] Delays in diagnosis and treatment are common and should be avoided. […] The goals of treatment are to provide satisfactory pain and symptom relief and reduce the disturbance in daily activities. […] Therapeutic options should take into account a patient’s contraceptive needs, as both nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives are considered first-line agents, either separately or in combination.

• #33 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your provider checks for anything unusual with the reproductive organs and looks for signs of infection. […] Your provider may also recommend certain tests, including: […] Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries. […] Other imaging tests. A computed tomography (CT) scan or Magnetic resonance imaging (MRI) scan provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. […] Laparoscopy. Although not usually necessary to diagnosis menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.

• #34 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html/1000

  Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected.

• #35 Exams and Tests Used to Investigate Menstrual Disorders – Your Period

  https://www.yourperiod.ca/abnormal-pain-and-menstrual-bleeding/exams-and-tests-used-to-investigate-menstrual-disorders/

  This procedure allows your doctor to see inside your uterus, using an instrument called a hysteroscope. […] This is a test that involves introducing a special type of dye into your uterus and fallopian tubes, and then taking an x-ray. […] This procedure is also called saline infusion sonography. […] An MRI is short for ‘magnetic resonance imaging’, which uses a powerful magnetic field to produce highly detailed images of the body’s internal structures. […] This test involves taking a sample of cervical cells and examining them for potentially cancerous cells. […] This procedure involves removing a small sample of tissue from the lining of the uterus in order to assess the health of the endometrium. […] This procedure involves the removal of tissue from the inside of the uterus. […] A colonoscope is a thin, flexible tube, with a camera and a light on the end of it. […] A cystoscope is a thin tube, with a camera and a light on the end.

• #36 Period Pain- Symptoms, Diagnosis, And Treatment | 24-7Medcare

  https://24-7medcare.com.au/pain/period-pain/

  Magnetic resonance imaging uses powerful magnets to take detailed 2D and 3D images inside the body. Similarly to ultrasound, it is used to diagnose other relevant conditions, especially if the different tests are not conclusive. […] GPs may also recommend blood tests in some situations. If heavy bleeding is associated with unusual period pain, anaemia (low red blood cells) could occur. […] A swab of your vagina or cervix may be taken for further laboratory testing. These tests are used to look for infections, such as chlamydia and gonorrhoea, that could be responsible for unusual period pain. […] A hysteroscopy is performed by looking inside the cervix and uterus using an instrument called a hysteroscope. Biopsies (tissue samples) can be taken for further analysis to determine a diagnosis or cause of the period pain.

• #37

  https://asktia.com/article/painful-period-cramps/

  CT or MRI These scans provide much greater detail than ultrasound and can help your provider diagnose any underlying cause(s) of secondary dysmenorrhea. […] Laparoscopy In more extreme cases, your provider might recommend an outpatient surgical procedure to get a better look at your abdominal cavity and reproductive organs. Laparoscopy, which entails making small incisions in the belly and inserting a thin camera, is the gold standard for diagnosing (and often treating) endometriosis, adhesions, fibroids, ovarian cysts, and other possible causes of secondary dysmenorrhea. […] Treatment for period cramps usually begins with NSAIDS (nonsteroidal anti-inflammatory drugs), like ibuprofen (Advil, Motrin) and naproxen (Aleve). […] If painful cramps are being caused by a secondary source, like endometriosis or fibroids, surgery might reduce symptoms.

• #38 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your provider checks for anything unusual with the reproductive organs and looks for signs of infection. […] Your provider may also recommend certain tests, including: […] Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries. […] Other imaging tests. A computed tomography (CT) scan or Magnetic resonance imaging (MRI) scan provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. […] Laparoscopy. Although not usually necessary to diagnosis menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.

• #39 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html/1000

  Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected.

• #40

  https://asktia.com/article/painful-period-cramps/

  CT or MRI These scans provide much greater detail than ultrasound and can help your provider diagnose any underlying cause(s) of secondary dysmenorrhea. […] Laparoscopy In more extreme cases, your provider might recommend an outpatient surgical procedure to get a better look at your abdominal cavity and reproductive organs. Laparoscopy, which entails making small incisions in the belly and inserting a thin camera, is the gold standard for diagnosing (and often treating) endometriosis, adhesions, fibroids, ovarian cysts, and other possible causes of secondary dysmenorrhea. […] Treatment for period cramps usually begins with NSAIDS (nonsteroidal anti-inflammatory drugs), like ibuprofen (Advil, Motrin) and naproxen (Aleve). […] If painful cramps are being caused by a secondary source, like endometriosis or fibroids, surgery might reduce symptoms.

• #41 Dysmenorrhea and Endometriosis in the Adolescent | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/dysmenorrhea-and-endometriosis-in-the-adolescent

  Dysmenorrhea, or menstrual pain, is the most common menstrual symptom among adolescent girls and young women. […] Most adolescents experiencing dysmenorrhea have primary dysmenorrhea, defined as painful menstruation in the absence of pelvic pathology. […] Secondary dysmenorrhea refers to painful menses due to pelvic pathology or a recognized medical condition. […] The most common cause of secondary dysmenorrhea is endometriosis. […] Although the true prevalence of endometriosis in adolescents is unknown, at least two thirds of adolescent girls with chronic pelvic pain or dysmenorrhea unresponsive to hormonal therapies and NSAIDs will be diagnosed with endometriosis at the time of diagnostic laparoscopy. […] Endometriosis should be considered in patients with persistent, clinically significant dysmenorrhea despite treatment with hormonal agents and nonsteroidal antiinflammatory drugs, particularly if no other etiology for chronic pelvic pain or secondary dysmenorrhea has been identified based on history, physical examination, and pelvic ultrasonography.

• #42 Menstrual Cramps: Symptoms, Treatment, and More

  https://www.everydayhealth.com/menstrual-cramps/guide/

  A doctor can diagnose either primary or secondary dysmenorrhea after discussing your symptoms, reviewing your medical history, performing a physical exam, and doing certain tests that can check for related health conditions. […] Some of these tests include: […] A pelvic exam: A physical exam of the female reproductive organs […] Ultrasound: An imaging test that examines the uterus, cervix, fallopian tubes, and ovaries […] Laparoscopy: An outpatient surgical procedure where a doctor makes small incisions in the abdomen and a thin tube (laparoscope) containing a light and camera is inserted to examine the pelvic organs […] If no causes of secondary dysmenorrhea are found, you may be diagnosed with primary dysmenorrhea.

• #43 Cramps but No Period: Causes and Diagnosis

  https://www.webmd.com/women/cramps-but-no-period

  Cramps but No Periods: Diagnosis […] Always call a doctor if you have cramps that wont go away, whether or not you have your period. (Get medical help right away if you have sudden, severe belly pain that continues to get worse.) […] Your doctor will want to know if your pain is sudden or ongoing. The more details you can give, the faster they may be able to diagnose and treat you. Youll be asked questions about your symptoms and your periods. […] Your doctor may do tests or procedures to learn the cause of your cramps. If your doctor suspects it is related to your uterus, or ovaries, common tests are: […] Pelvic exam […] Ultrasound […] Laparoscopy, a type of exploratory surgery to look at the structures inside your pelvic area, including your uterus, cervix, ovaries, and fallopian tubes

• #44 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html

  A pelvic examination should be performed in all sexually active patients with dysmenorrhea and in those in whom endometriosis is suspected. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. […] Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

• #45 Patient education: Painful menstrual periods (dysmenorrhea) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/painful-menstrual-periods-dysmenorrhea-beyond-the-basics

  Typical next steps — If neither NSAIDs nor hormonal birth control adequately improve pain, your provider can recommend next steps based on your age, symptoms, and other medical conditions. Options include: […] Surgery to identify a cause – Diagnostic laparoscopy may be recommended to determine if endometriosis, or another condition, could be causing the pain.

• #46 Dysmenorrhea and Endometriosis in the Adolescent | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/dysmenorrhea-and-endometriosis-in-the-adolescent

  Endometriosis remains a surgical and pathologic diagnosis in adolescents requiring the presence of endometrial glands and stroma in the biopsy specimen from a location outside of the endometrial cavity. […] The appearance of endometriosis may be different in an adolescent than in an adult woman. In adolescents, endometriotic lesions are typically clear or red and can be difficult to identify for gynecologists unfamiliar with endometriosis in adolescents. […] Recommended treatment for endometriosis in adolescents is conservative surgical therapy for diagnosis and treatment combined with ongoing suppressive medical therapies to prevent endometrial proliferation. […] Patients with endometriosis who have pain refractory to conservative surgical therapy and suppressive hormonal therapy often benefit from at least 6 months of gonadotropin-releasing hormone (GnRH) agonist therapy with add-back medicine. […] Nonsteroidal antiinflammatory drugs should be the mainstay of pain relief for adolescents with endometriosis. […] Adolescents should not be prescribed narcotics long-term to manage endometriosis outside of a specialized pain management team.

• #47 Exams and Tests Used to Investigate Menstrual Disorders – Your Period

  https://www.yourperiod.ca/abnormal-pain-and-menstrual-bleeding/exams-and-tests-used-to-investigate-menstrual-disorders/

  This procedure allows your doctor to see inside your uterus, using an instrument called a hysteroscope. […] This is a test that involves introducing a special type of dye into your uterus and fallopian tubes, and then taking an x-ray. […] This procedure is also called saline infusion sonography. […] An MRI is short for ‘magnetic resonance imaging’, which uses a powerful magnetic field to produce highly detailed images of the body’s internal structures. […] This test involves taking a sample of cervical cells and examining them for potentially cancerous cells. […] This procedure involves removing a small sample of tissue from the lining of the uterus in order to assess the health of the endometrium. […] This procedure involves the removal of tissue from the inside of the uterus. […] A colonoscope is a thin, flexible tube, with a camera and a light on the end of it. […] A cystoscope is a thin tube, with a camera and a light on the end.

• #48 Menstrual Cramps Causes and Treatments

  https://www.webmd.com/women/menstrual-pain

  Menstrual Pain Diagnosis […] The doctor will ask about your medical history, as well as questions about the menstrual pain and symptoms. Be prepared to talk about these details: […] The doctor will perform a pelvic exam to check for any problems. If there are concerns about a possible infection, cervical cultures and a blood test will confirm the diagnosis. You might get these tests, too: […] An ultrasound exam is necessary if the doctor discovers any abnormal masses during the pelvic exam or there is a new onset of menstrual pain. […] A doctor may recommend a laparoscopy, which is a minor surgical procedure allowing the doctor to look directly into the pelvic cavity with a fiber-optic scope. This is an outpatient procedure using very small incisions. […] A hysteroscopy is another possible procedure. By inserting a hysteroscope (a thin lighted tube) through the vagina, the doctor can see inside the cervix and the inside of the uterus without incisions. This can be done in a doctor’s office or a hospital.

• #49 Period Pain- Symptoms, Diagnosis, And Treatment | 24-7Medcare

  https://24-7medcare.com.au/pain/period-pain/

  Magnetic resonance imaging uses powerful magnets to take detailed 2D and 3D images inside the body. Similarly to ultrasound, it is used to diagnose other relevant conditions, especially if the different tests are not conclusive. […] GPs may also recommend blood tests in some situations. If heavy bleeding is associated with unusual period pain, anaemia (low red blood cells) could occur. […] A swab of your vagina or cervix may be taken for further laboratory testing. These tests are used to look for infections, such as chlamydia and gonorrhoea, that could be responsible for unusual period pain. […] A hysteroscopy is performed by looking inside the cervix and uterus using an instrument called a hysteroscope. Biopsies (tissue samples) can be taken for further analysis to determine a diagnosis or cause of the period pain.

• #50 Period Pain- Symptoms, Diagnosis, And Treatment | 24-7Medcare

  https://24-7medcare.com.au/pain/period-pain/

  Magnetic resonance imaging uses powerful magnets to take detailed 2D and 3D images inside the body. Similarly to ultrasound, it is used to diagnose other relevant conditions, especially if the different tests are not conclusive. […] GPs may also recommend blood tests in some situations. If heavy bleeding is associated with unusual period pain, anaemia (low red blood cells) could occur. […] A swab of your vagina or cervix may be taken for further laboratory testing. These tests are used to look for infections, such as chlamydia and gonorrhoea, that could be responsible for unusual period pain. […] A hysteroscopy is performed by looking inside the cervix and uterus using an instrument called a hysteroscope. Biopsies (tissue samples) can be taken for further analysis to determine a diagnosis or cause of the period pain.

• #51 Dysmenorrhea Workup: Approach Considerations, Laboratory Studies, Ultrasonography and Other Imaging Studies

  https://emedicine.medscape.com/article/253812-workup

  No tests are specific to the diagnosis of primary dysmenorrhea. The diagnosis is made on the basis of clinical findings. […] Laboratory studies may be indicated to elucidate potential causes of secondary dysmenorrhea. Noninvasive studies may include abdominal and transvaginal ultrasonography. Other more invasive studies, including hysterosalpingography, may be required. Further investigation might include hysteroscopy or laparoscopy; the latter is usually indicated when initial interventions fail to relieve symptoms. […] The following laboratory studies may be performed to identify or exclude organic causes of secondary dysmenorrhea: Complete blood cell count (CBC) with differential to search for evidence of infection or a neoplastic process […] Gonococcal and chlamydial cultures, enzyme immunoassay (EIA), and DNA probe testing to exclude sexually transmitted infections (STIs) and pelvic inflammatory disease (PID)

• #52 Dysmenorrhea Workup: Approach Considerations, Laboratory Studies, Ultrasonography and Other Imaging Studies

  https://emedicine.medscape.com/article/253812-workup

  Quantitative human chorionic gonadotropin level to exclude ectopic pregnancy […] Erythrocyte sedimentation rate (ESR) for subacute salpingitis […] Urinalysis to exclude urinary tract infection […] Stool guaiac to rule out GI bleeding. […] Accordingly, for diagnosing dysmenorrhea and its underlying cause, laboratory testing should be understood to play an ancillary rather than a primary role and should not be allowed to replace a sound clinical basis for the diagnosis. […] In cases of well-established primary dysmenorrhea, imaging studies are of little value. However, if pelvic pathology is suspected, abdominal and transvaginal ultrasonography are inexpensive and effective modalities. […] Hysterosalpingography and saline infused sonohysterography can be used to exclude endometrial polyps, leiomyomas, and congenital abnormalities of the uterus.

• #53 Period Pain- Symptoms, Diagnosis, And Treatment | 24-7Medcare

  https://24-7medcare.com.au/pain/period-pain/

  Magnetic resonance imaging uses powerful magnets to take detailed 2D and 3D images inside the body. Similarly to ultrasound, it is used to diagnose other relevant conditions, especially if the different tests are not conclusive. […] GPs may also recommend blood tests in some situations. If heavy bleeding is associated with unusual period pain, anaemia (low red blood cells) could occur. […] A swab of your vagina or cervix may be taken for further laboratory testing. These tests are used to look for infections, such as chlamydia and gonorrhoea, that could be responsible for unusual period pain. […] A hysteroscopy is performed by looking inside the cervix and uterus using an instrument called a hysteroscope. Biopsies (tissue samples) can be taken for further analysis to determine a diagnosis or cause of the period pain.

• #54 Menstrual Pain Mana | Haleon HealthPartner

  https://www.haleonhealthpartner.com/en-us/pain-relief/conditions/menstrual-pain/management/

  If you suspect the patient has secondary dysmenorrhea, consider the following methods of diagnosis: Transvaginal ultrasonography to detect endometriomas of the bowels or ovaries, Urinary human chorionic gonadotropic pregnancy test, Vaginal and endocervical swabs, Complete blood count, Urinalysis, Cervical cytology, Magnetic resonance imaging if other findings are inconclusive.

• #55 Menstrual Cramps – Women’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/menstrual-cramps

  Testing is done to rule out disorders that may be causing the pain. For most women, tests include a pregnancy test in all women of reproductive age, Ultrasonography of the pelvis to check for fibroids, endometriosis, adenomyosis, and cysts in the ovaries. […] If pelvic inflammatory disease is suspected, a sample of secretions is taken from the cervix, examined under a microscope, and sent to a laboratory to be tested. […] If results of these tests are unclear and symptoms persist, one or more of the following tests is done: Imaging tests such as hysterosalpingography or sonohysterography to identify polyps, fibroids, and birth defects, Hysteroscopy to identify problems with the cervix or uterus (but not with the ovaries), Magnetic resonance imaging (MRI) to identify other abnormalities, Laparoscopy if results of other tests are unclear.

• #56 Menstrual Pain Mana | Haleon HealthPartner

  https://www.haleonhealthpartner.com/en-us/pain-relief/conditions/menstrual-pain/management/

  If you suspect the patient has secondary dysmenorrhea, consider the following methods of diagnosis: Transvaginal ultrasonography to detect endometriomas of the bowels or ovaries, Urinary human chorionic gonadotropic pregnancy test, Vaginal and endocervical swabs, Complete blood count, Urinalysis, Cervical cytology, Magnetic resonance imaging if other findings are inconclusive.

• #57 Menstrual Cramps – Women’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/menstrual-cramps

  For hysterosalpingography, x-rays are taken after a substance that can be seen on x-rays (radiopaque contrast agent) is injected through the cervix into the uterus and fallopian tubes. […] For sonohysterography, ultrasonography is done after fluid is infused in the uterus through a thin tube inserted through the vagina and cervix. […] For hysteroscopy, doctors insert a thin viewing tube through the vagina and cervix to view the interior of the uterus. […] For laparoscopy, a viewing tube is inserted through a small incision just below the navel and is used to view the uterus, fallopian tubes, ovaries, and organs in the abdomen.

• #58 Menstrual Cramps – Women’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/menstrual-cramps

  For hysterosalpingography, x-rays are taken after a substance that can be seen on x-rays (radiopaque contrast agent) is injected through the cervix into the uterus and fallopian tubes. […] For sonohysterography, ultrasonography is done after fluid is infused in the uterus through a thin tube inserted through the vagina and cervix. […] For hysteroscopy, doctors insert a thin viewing tube through the vagina and cervix to view the interior of the uterus. […] For laparoscopy, a viewing tube is inserted through a small incision just below the navel and is used to view the uterus, fallopian tubes, ovaries, and organs in the abdomen.

• #59 Dysmenorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/253812-differential

  The key diagnostic issue in dysmenorrhea is differentiating primary dysmenorrhea from secondary dysmenorrhea. […] In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following: […] Uterine neoplasm, benign or malignant. […] Differential Diagnoses: Adenomyosis. […] Ectopic Pregnancy. […] Endometriosis. […] Pelvic Inflammatory Disease.

• #60 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  A diagnosis can often be reached by obtaining a detailed medical, family, psychosocial, and gynecologic (including menstrual and sexual) history. […] The onset of primary dysmenorrhea typically begins 6 to 24 months after menarche. […] Generally, symptoms begin a few hours before or after menstrual blood flow, peak at the time of heaviest blood flow, and resolve on cycle day 2 or 3. […] The timing, quality, duration, and location of pain associated with primary dysmenorrhea is consistent from one menstrual cycle to the next and does not progressively worsen with time. […] A pelvic examination is recommended in adult women presenting for the first time with dysmenorrhea because the likelihood of secondary causes is much higher in this population. […] However, a pelvic exam is not necessary in nonsexually active patients specifically adolescents if the elicited history is descriptive of primary dysmenorrhea.

• #61 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Primary dysmenorrhea may be diagnosed based on the typical history alone. Pain begins just before or at the start of menstrual bleeding. It is cyclic and begins with the onset of ovulatory cycles, usually within 2 years of menarche. […] A pelvic examination is important for evaluating dysmenorrhea if the history of onset and duration of lower abdominal pain suggests secondary dysmenorrhoea or if the dysmenorrhea is not responding to medical treatment. […] Treatment of dysmenorrhea is aimed at providing adequate pain relief to allow patients to perform most of their daily activities. Treatment for primary and secondary dysmenorrhea begins similarly. […] If symptoms do not respond to initial treatments, an evaluation for potential causes of secondary dysmenorrhea may be warranted. […] Common findings that may indicate secondary dysmenorrhea include older age versus younger age, vaginal discharge that is whitish gray, mucopurulent, or has a foul odor, and heavy menstrual bleeding with a mildly enlarged symmetrical uterus. […] The differential diagnosis of dysmenorrhea is broad. It can be categorized as gynecological conditions and non-gynecological conditions. […] The prognosis for primary dysmenorrhea is generally good. Mild and moderate dysmenorrhea usually responds well to NSAIDs. […] The prognosis of secondary dysmenorrhea depends on the etiology, type, location, and severity of the cause.

• #62 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://kjfm.or.kr/journal/view.php?number=4607

  However, a pelvic examination should be conducted on sexually active females experiencing symptoms of sexually transmitted diseases or pelvic inflammatory disease, or those with severe dysmenorrhea. […] The presence of any such symptoms mandates the necessity of a pelvic examination, and in some instances, performing transvaginal ultrasonography, or magnetic resonance imaging. Normal pelvic examination findings may also confirm the diagnosis of PD.

• #63 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8943241/

  SD should be suspected if the patient reports an immediate or delayed onset of dysmenorrhea after menarche; severe symptoms associated with abnormal menstrual bleeding; irregularities and worsening of symptoms; dyspareunia, family history of endometriosis; or conventional therapy response failure. […] Normal pelvic examination findings may also confirm the diagnosis of PD.

• #64 Dysmenorrhea and Endometriosis in the Adolescent | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/dysmenorrhea-and-endometriosis-in-the-adolescent

  Dysmenorrhea, or menstrual pain, is the most common menstrual symptom among adolescent girls and young women. […] Most adolescents experiencing dysmenorrhea have primary dysmenorrhea, defined as painful menstruation in the absence of pelvic pathology. […] Secondary dysmenorrhea refers to painful menses due to pelvic pathology or a recognized medical condition. […] The most common cause of secondary dysmenorrhea is endometriosis. […] Although the true prevalence of endometriosis in adolescents is unknown, at least two thirds of adolescent girls with chronic pelvic pain or dysmenorrhea unresponsive to hormonal therapies and NSAIDs will be diagnosed with endometriosis at the time of diagnostic laparoscopy. […] Endometriosis should be considered in patients with persistent, clinically significant dysmenorrhea despite treatment with hormonal agents and nonsteroidal antiinflammatory drugs, particularly if no other etiology for chronic pelvic pain or secondary dysmenorrhea has been identified based on history, physical examination, and pelvic ultrasonography.

• #65 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Primary dysmenorrhea may be diagnosed based on the typical history alone. Pain begins just before or at the start of menstrual bleeding. It is cyclic and begins with the onset of ovulatory cycles, usually within 2 years of menarche. […] A pelvic examination is important for evaluating dysmenorrhea if the history of onset and duration of lower abdominal pain suggests secondary dysmenorrhoea or if the dysmenorrhea is not responding to medical treatment. […] Treatment of dysmenorrhea is aimed at providing adequate pain relief to allow patients to perform most of their daily activities. Treatment for primary and secondary dysmenorrhea begins similarly. […] If symptoms do not respond to initial treatments, an evaluation for potential causes of secondary dysmenorrhea may be warranted. […] Common findings that may indicate secondary dysmenorrhea include older age versus younger age, vaginal discharge that is whitish gray, mucopurulent, or has a foul odor, and heavy menstrual bleeding with a mildly enlarged symmetrical uterus. […] The differential diagnosis of dysmenorrhea is broad. It can be categorized as gynecological conditions and non-gynecological conditions. […] The prognosis for primary dysmenorrhea is generally good. Mild and moderate dysmenorrhea usually responds well to NSAIDs. […] The prognosis of secondary dysmenorrhea depends on the etiology, type, location, and severity of the cause.

• #66 Period pain (dysmenorrhoea) | NHS inform

  https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/period-pain-dysmenorrhoea/

  Period pain should not be severe. Speak to your doctor if youre experiencing pain which is affecting your day to day life. […] If you experience severe period pain that stops you from doing day-to-day things, or that worries you at all, you should speak to your doctor. Its important to get checked if you have any worries you dont need to suffer. […] Your doctor will usually examine you if they think that you have secondary dysmenorrhoea. This may involve an internal examination to check your womb (uterus) and pelvis as well as your tummy (abdomen). […] The doctor will look for the possible cause of your painful periods. […] If your doctor thinks that you have secondary dysmenorrhoea, they may refer you to a specialist (usually a doctor called a gynaecologist). […] Treatment for secondary dysmenorrhoea will depend on its cause. Your doctor will be able to advise on the best course of treatment for your symptoms and condition and they will discuss this with you.

• #67 Dysmenorrhea: Painful Periods | ACOG

  https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods

  Pain associated with menstruation is called dysmenorrhea. […] Most women have some pain with their menstrual periods. […] There are two types of dysmenorrhea: primary and secondary. […] Primary dysmenorrhea is the cramping pain that comes before or during a period. […] Secondary dysmenorrhea is caused by a disorder in the reproductive organs. […] Some of the conditions that can cause secondary dysmenorrhea include the following: Endometriosis, Fibroids, Adenomyosis, Problems with the uterus, fallopian tubes, and other reproductive organs, Other conditions. […] Yes, if you have painful periods you and your obstetrician-gynecologist (ob-gyn) should talk about your symptoms and your menstrual cycle. […] An ultrasound exam may be done when pain is not relieved with medications. […] Medications are usually the first step when treating painful periods.

• #68 Menstrual cramps: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/157333

  Menstrual cramps are painful sensations that affect many people before and during a menstrual period. […] Pain that only occurs with menstruation is known as primary dysmenorrhea. Secondary dysmenorrhea is period pain that stems from a medical problem, such as endometriosis, uterine fibroids, or pelvic inflammatory disease. […] People should see a doctor if: the symptoms are severe or get progressively worse; pain is present at other times, not just around menstruation. […] Over-the-counter pain relievers are often effective in easing menstrual cramps. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can often relieve the pain. […] In some cases, a doctor may prescribe hormonal birth control pills to prevent ovulation and reduce the severity of menstrual cramps. […] If the cramps are due to an underlying medical condition, such as endometriosis or fibroids, a doctor may recommend surgery to remove the unwanted tissue. […] Several underlying medical conditions can also cause or worsen menstrual cramps. […] If these cause severe symptoms, a person may need surgery. […] If the symptoms are severe or occur at other times in the month, it is a good idea to see a doctor.

• #69 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. […] Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. […] See your health care provider if: Menstrual cramps disrupt your life every month. […] Menstrual cramps can be caused by: Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis. […] Menstrual cramps don’t cause other medical complications, but they can interfere with school, work and social activities.

• #70 Diagnosis and Initial Management of Dysmenorrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0301/p341.html/1000

  Adenomyosis is the presence of endometrial glands and stroma within the myometrium. Symptoms and signs include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Diagnosis is usually confirmed through transvaginal ultrasonography and magnetic resonance imaging. […] One or more findings of uterine tenderness, adnexal tenderness, or cervical motion tenderness should raise the suspicion for PID. Additional criteria include oral temperature greater than 101F (38.3C), abnormal cervical or vaginal mucopurulent discharge, abundant white blood cells on saline microscopy of vaginal fluid, elevated erythrocyte sedimentation rate, elevated C-reactive protein level, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. […] The diagnosis of primary dysmenorrhea is based on the clinical history and physical examination. Laparoscopy is indicated if the etiology remains unknown after an appropriate noninvasive evaluation has been completed. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected.

• #71 Menstrual Cramps

  https://www.seattlechildrens.org/conditions/a-z/menstrual-cramps/

  Cramps in the lower belly or pelvis. They start during the first 1 or 2 days of a girl’s period. […] The medical name for painful cramping during a girl’s period is dysmenorrhea. […] Medical causes of severe menstrual cramps include pelvic inflammatory disease (PID) and endometriosis. An ovarian cyst can also cause very bad cramping. […] Cramps last more than 3 days. […] Cramps keep your teen from doing normal activities even after using pain medicine. […] Call your doctor if neither ibuprofen or naproxen helps the pain. […] Cramps cause her to miss school or other events. […] Pain lasts over 3 days.

• #72 Period pain

  https://www.nhs.uk/conditions/period-pain/

  Period pain usually happens to women around the start of their period. It can affect anyone who has periods. […] You may have period pain if: you have pain in your tummy at the start of your period, or several days before your period; you have painful cramps in your tummy that spread to your back and thighs; you have a sharp pain or a dull ache in your tummy. […] Period pain happens when your womb tightens during your period. It’s often a normal part of the menstrual cycle. […] Sometimes painful periods can be caused by a condition such as: womb tissue growing in other places (endometriosis and adenomyosis); growths in and around the womb (fibroids); an infection of the womb, fallopian tubes and ovaries (pelvic inflammatory disease). […] You might need tests, such as an ultrasound scan, to find out what’s causing your period pain. If a condition is found, treating it will help.

• #73 Period pain (dysmenorrhoea) | NHS inform

  https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/period-pain-dysmenorrhoea/

  Period pain should not be severe. Speak to your doctor if youre experiencing pain which is affecting your day to day life. […] If you experience severe period pain that stops you from doing day-to-day things, or that worries you at all, you should speak to your doctor. Its important to get checked if you have any worries you dont need to suffer. […] Your doctor will usually examine you if they think that you have secondary dysmenorrhoea. This may involve an internal examination to check your womb (uterus) and pelvis as well as your tummy (abdomen). […] The doctor will look for the possible cause of your painful periods. […] If your doctor thinks that you have secondary dysmenorrhoea, they may refer you to a specialist (usually a doctor called a gynaecologist). […] Treatment for secondary dysmenorrhoea will depend on its cause. Your doctor will be able to advise on the best course of treatment for your symptoms and condition and they will discuss this with you.

• #74 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://kjfm.or.kr/journal/view.php?number=4607

  Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. […] While its diagnosis is based on patients history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). […] The diagnosis of PD is made mainly by retrieving a focused medical history and performing a physical examination to exclude the presence of pelvic pathology, as shown in Figure 1. […] Since females with typical symptoms of PD can be diagnosed solely on the basis of their medical information, without any physical or pelvic examination, empiric treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs) and/or oral contraceptives should be initiated.

• #75 Painful Menstrual Periods: Causes, Treatments & More

  https://www.healthline.com/health/painful-menstrual-periods

  Painful menstruation is called dysmenorrhea. There are two types: primary and secondary. Certain medical conditions, including endometriosis and pelvic inflammatory disease, can cause it. […] Primary dysmenorrhea occurs in people who experience pain before and during menstruation. If you’ve had normal periods that become painful later in life, it may be secondary dysmenorrhea. A condition affecting the uterus or other pelvic organs, such as endometriosis or uterine fibroids, can cause this. […] When trying to find out what the underlying cause of painful menstruation is, your doctor will likely take your medical history and perform a physical exam. This will include a pelvic exam to check for any abnormalities in your reproductive system and to look for signs of infection. […] If your doctor thinks an underlying disorder is causing your symptoms, they may perform imaging tests. These can include: an ultrasound, a CT scan, an MRI. […] Depending on the results of your imaging tests, your doctor may order a laparoscopy. This is a test in which a doctor makes small incisions in the abdomen into which they insert a fiber-optic tube with a camera at the end to see inside your abdominal cavity.

• #76 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8943241/

  Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. […] While its diagnosis is based on patients history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). […] The diagnosis of PD is made mainly by retrieving a focused medical history and performing a physical examination to exclude the presence of pelvic pathology. […] Since females with typical symptoms of PD can be diagnosed solely on the basis of their medical information, without any physical or pelvic examination, empiric treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs) and/or oral contraceptives should be initiated.

• #77 Dysmenorrhea Workup: Approach Considerations, Laboratory Studies, Ultrasonography and Other Imaging Studies

  https://emedicine.medscape.com/article/253812-workup

  On occasion, other more invasive studies, including laparoscopy, hysteroscopy, and dilatation and curettage (DC), may be required. […] Laparoscopic examination is the single most useful procedure. It involves a complete diagnostic survey of the pelvis and reproductive organs to ascertain the presence of any pathology that may account for the clinical symptoms.

• #78 Patient education: Painful menstrual periods (dysmenorrhea) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/painful-menstrual-periods-dysmenorrhea-beyond-the-basics

  Typical next steps — If neither NSAIDs nor hormonal birth control adequately improve pain, your provider can recommend next steps based on your age, symptoms, and other medical conditions. Options include: […] Surgery to identify a cause – Diagnostic laparoscopy may be recommended to determine if endometriosis, or another condition, could be causing the pain.

• #79 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8943241/

  Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. […] While its diagnosis is based on patients history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). […] The diagnosis of PD is made mainly by retrieving a focused medical history and performing a physical examination to exclude the presence of pelvic pathology. […] Since females with typical symptoms of PD can be diagnosed solely on the basis of their medical information, without any physical or pelvic examination, empiric treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs) and/or oral contraceptives should be initiated.

• #80 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://kjfm.or.kr/journal/view.php?number=4607

  However, a pelvic examination should be conducted on sexually active females experiencing symptoms of sexually transmitted diseases or pelvic inflammatory disease, or those with severe dysmenorrhea. […] The presence of any such symptoms mandates the necessity of a pelvic examination, and in some instances, performing transvaginal ultrasonography, or magnetic resonance imaging. Normal pelvic examination findings may also confirm the diagnosis of PD.

• #81 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  The pelvic exam should be normal in patients with primary dysmenorrhea when not menstruating. […] Transvaginal ultrasonography is the preferred method for the initial evaluation of pelvic organs. […] Although endometriosis is a common cause of secondary dysmenorrhea, routine pelvic ultrasound is frequently unremarkable in affected patients unless there is anatomic distortion, endometrioma, or evidence of deep infiltrative endometriosis. […] Delays in diagnosis and treatment are common and should be avoided. […] The goals of treatment are to provide satisfactory pain and symptom relief and reduce the disturbance in daily activities. […] Therapeutic options should take into account a patient’s contraceptive needs, as both nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives are considered first-line agents, either separately or in combination.

• #82 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  Randomized, placebo-controlled trials support the efficacy of NSAIDs in the treatment of primary dysmenorrhea. […] Patients are encouraged to continue first-line therapy for 3 to 6 months, and their response to therapy should be monitored 2 to 3 months after its initiation. […] If adequate relief of symptoms is not achieved, further evaluation or referral to gynecologic specialists is recommended. […] Gynecologists play an important role in building patient and community awareness of the condition, and in its diagnosis and management. […] Progressive worsening of symptoms or suboptimal symptom control with first-line agents warrants further evaluation for secondary causes, including endometriosis.

• #83 Period pain (dysmenorrhoea) | NHS inform

  https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/period-pain-dysmenorrhoea/

  Period pain should not be severe. Speak to your doctor if youre experiencing pain which is affecting your day to day life. […] If you experience severe period pain that stops you from doing day-to-day things, or that worries you at all, you should speak to your doctor. Its important to get checked if you have any worries you dont need to suffer. […] Your doctor will usually examine you if they think that you have secondary dysmenorrhoea. This may involve an internal examination to check your womb (uterus) and pelvis as well as your tummy (abdomen). […] The doctor will look for the possible cause of your painful periods. […] If your doctor thinks that you have secondary dysmenorrhoea, they may refer you to a specialist (usually a doctor called a gynaecologist). […] Treatment for secondary dysmenorrhoea will depend on its cause. Your doctor will be able to advise on the best course of treatment for your symptoms and condition and they will discuss this with you.

• #84 Period Pain (Dysmenorrhoea): Causes and Treatment

  https://patient.info/womens-health/period-pain-dysmenorrhoea

  Most women have some pain during periods. […] Doctors may call period pain 'dysmenorrhoea’. […] The cause is often not clear (this is called primary dysmenorrhoea). […] In primary dysmenorrhoea, the womb (uterus) is normal. […] A problem of the womb or pelvis sometimes causes painful periods. […] Again, the main symptom is lower tummy pain during your periods (menstrual cramps). […] In many cases (particularly in teenagers) the symptoms are so typical that it can be confidently diagnosed by your doctor just by asking about your symptoms. […] Your doctor will usually examine you if they suspect that you have secondary dysmenorrhoea. […] If your GP feels that you have secondary dysmenorrhoea, they may arrange further tests (such as an ultrasound scan) or refer you to a specialist (usually a gynaecologist) for their opinion and other investigations. […] The treatment of secondary dysmenorrhoea depends on the underlying cause.

• #85 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  Randomized, placebo-controlled trials support the efficacy of NSAIDs in the treatment of primary dysmenorrhea. […] Patients are encouraged to continue first-line therapy for 3 to 6 months, and their response to therapy should be monitored 2 to 3 months after its initiation. […] If adequate relief of symptoms is not achieved, further evaluation or referral to gynecologic specialists is recommended. […] Gynecologists play an important role in building patient and community awareness of the condition, and in its diagnosis and management. […] Progressive worsening of symptoms or suboptimal symptom control with first-line agents warrants further evaluation for secondary causes, including endometriosis.

• #86 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  Randomized, placebo-controlled trials support the efficacy of NSAIDs in the treatment of primary dysmenorrhea. […] Patients are encouraged to continue first-line therapy for 3 to 6 months, and their response to therapy should be monitored 2 to 3 months after its initiation. […] If adequate relief of symptoms is not achieved, further evaluation or referral to gynecologic specialists is recommended. […] Gynecologists play an important role in building patient and community awareness of the condition, and in its diagnosis and management. […] Progressive worsening of symptoms or suboptimal symptom control with first-line agents warrants further evaluation for secondary causes, including endometriosis.

• #87 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. […] Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. […] See your health care provider if: Menstrual cramps disrupt your life every month. […] Menstrual cramps can be caused by: Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis. […] Menstrual cramps don’t cause other medical complications, but they can interfere with school, work and social activities.

• #88 Dysmenorrhea: Menstrual Cramps, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea

  What youre feeling is a tightening and relaxing of your uterus. The muscles in your uterus contract in order to shed your uterine lining. […] If you have painful periods, you may feel: Aching, throbbing pain in your abdomen (pain may be severe at times). […] Menstrual pain from secondary dysmenorrhea is a result of a condition affecting your reproductive organs. […] If you have severe or unusual menstrual cramps or cramps that last for more than three days, contact a healthcare provider. […] First, your healthcare provider will ask you to describe your symptoms and menstrual cycles. […] However, if your provider thinks you may have secondary dysmenorrhea (caused by another health condition), you may need additional tests. […] Pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first treatment for dysmenorrhea.

• #89 Severe Menstrual Cramps: Normal vs. Severe Pain, Causes, Relief Tips

  https://www.healthline.com/health/severe-menstrual-cramps

  Menstrual cramps can range from a mild nuisance lasting a day or two to several days of unbearable pain that interferes with everyday activities. […] Severe cramps, however, tend to begin earlier in the menstrual cycle and last longer than typical cramps do. […] Not sure if your cramps are typical or severe? Generally, severe menstrual cramps: […] Some people tend to have more severe menstrual cramps without any clear cause. For others, severe menstrual cramps may be a symptom of an underlying medical condition. […] If you have very painful menstrual cramps or cramps that last longer than two or three days, make an appointment with your healthcare provider. […] Theyll likely start by reviewing your medical history and performing a physical exam, including a pelvic exam. […] Depending on your other symptoms, they may recommend additional tests, including: […] You dont have to power through severe menstrual cramps. If your pain interferes with your ability to go on about your day or lasts longer than two or three days, talk to your healthcare provider.

• #90 Menstrual Cramps

  https://www.seattlechildrens.org/conditions/a-z/menstrual-cramps/

  Cramps in the lower belly or pelvis. They start during the first 1 or 2 days of a girl’s period. […] The medical name for painful cramping during a girl’s period is dysmenorrhea. […] Medical causes of severe menstrual cramps include pelvic inflammatory disease (PID) and endometriosis. An ovarian cyst can also cause very bad cramping. […] Cramps last more than 3 days. […] Cramps keep your teen from doing normal activities even after using pain medicine. […] Call your doctor if neither ibuprofen or naproxen helps the pain. […] Cramps cause her to miss school or other events. […] Pain lasts over 3 days.

• #91 Severe Menstrual Cramps: Normal vs. Severe Pain, Causes, Relief Tips

  https://www.healthline.com/health/severe-menstrual-cramps

  Menstrual cramps can range from a mild nuisance lasting a day or two to several days of unbearable pain that interferes with everyday activities. […] Severe cramps, however, tend to begin earlier in the menstrual cycle and last longer than typical cramps do. […] Not sure if your cramps are typical or severe? Generally, severe menstrual cramps: […] Some people tend to have more severe menstrual cramps without any clear cause. For others, severe menstrual cramps may be a symptom of an underlying medical condition. […] If you have very painful menstrual cramps or cramps that last longer than two or three days, make an appointment with your healthcare provider. […] Theyll likely start by reviewing your medical history and performing a physical exam, including a pelvic exam. […] Depending on your other symptoms, they may recommend additional tests, including: […] You dont have to power through severe menstrual cramps. If your pain interferes with your ability to go on about your day or lasts longer than two or three days, talk to your healthcare provider.

• #92 Period Cramps: 9 Menstrual Pain Relief Tips | MOTRIN®

  https://www.motrin.com/adults/period/period-pain-relief

  The cramping pain that comes before and during a period is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. […] Talk to your doctor if you have any questions, if your symptoms get progressively worse, or if you started having severe cramps after age 25. […] Acupressure is a technique that stimulates certain points on the body with gentle pressure on the skin without the needles involved in acupuncture. It appears it may help to ease menstrual cramps. […] OTC pain relievers such as Ibuprofen, (in a class of medications called NSAIDs) can relieve minor aches and pains due to menstrual cramps. […] Women who report feeling stressed early in their monthly cycle were more likely than those who were less stressed to report more pronounced symptoms before and during menstruation, according to a study by researchers at the National Institutes of Health and other institutions. […] If self-care treatments dont provide relief, talk to your doctor.

• #93 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8943241/

  Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. […] While its diagnosis is based on patients history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). […] The diagnosis of PD is made mainly by retrieving a focused medical history and performing a physical examination to exclude the presence of pelvic pathology. […] Since females with typical symptoms of PD can be diagnosed solely on the basis of their medical information, without any physical or pelvic examination, empiric treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs) and/or oral contraceptives should be initiated.

• #94 Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

  https://kjfm.or.kr/journal/view.php?number=4607

  Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. […] While its diagnosis is based on patients history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). […] The diagnosis of PD is made mainly by retrieving a focused medical history and performing a physical examination to exclude the presence of pelvic pathology, as shown in Figure 1. […] Since females with typical symptoms of PD can be diagnosed solely on the basis of their medical information, without any physical or pelvic examination, empiric treatment, including nonsteroidal anti-inflammatory drugs (NSAIDs) and/or oral contraceptives should be initiated.

• #95 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  Randomized, placebo-controlled trials support the efficacy of NSAIDs in the treatment of primary dysmenorrhea. […] Patients are encouraged to continue first-line therapy for 3 to 6 months, and their response to therapy should be monitored 2 to 3 months after its initiation. […] If adequate relief of symptoms is not achieved, further evaluation or referral to gynecologic specialists is recommended. […] Gynecologists play an important role in building patient and community awareness of the condition, and in its diagnosis and management. […] Progressive worsening of symptoms or suboptimal symptom control with first-line agents warrants further evaluation for secondary causes, including endometriosis.

• #96 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Primary dysmenorrhea may be diagnosed based on the typical history alone. Pain begins just before or at the start of menstrual bleeding. It is cyclic and begins with the onset of ovulatory cycles, usually within 2 years of menarche. […] A pelvic examination is important for evaluating dysmenorrhea if the history of onset and duration of lower abdominal pain suggests secondary dysmenorrhoea or if the dysmenorrhea is not responding to medical treatment. […] Treatment of dysmenorrhea is aimed at providing adequate pain relief to allow patients to perform most of their daily activities. Treatment for primary and secondary dysmenorrhea begins similarly. […] If symptoms do not respond to initial treatments, an evaluation for potential causes of secondary dysmenorrhea may be warranted. […] Common findings that may indicate secondary dysmenorrhea include older age versus younger age, vaginal discharge that is whitish gray, mucopurulent, or has a foul odor, and heavy menstrual bleeding with a mildly enlarged symmetrical uterus. […] The differential diagnosis of dysmenorrhea is broad. It can be categorized as gynecological conditions and non-gynecological conditions. […] The prognosis for primary dysmenorrhea is generally good. Mild and moderate dysmenorrhea usually responds well to NSAIDs. […] The prognosis of secondary dysmenorrhea depends on the etiology, type, location, and severity of the cause.

• #97 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  Primary dysmenorrhea is a prevalent, underdiagnosed, but treatable condition. […] Primary dysmenorrhea is defined as painful menstruation in the absence of an identifiable cause. […] The management of primary dysmenorrhea is directed toward diagnosing other causes of symptoms and identifying medical therapies that satisfactorily control the patients symptoms. […] Despite its high prevalence, dysmenorrhea is often underdiagnosed, inadequately treated, and normalized even by patients themselves, who may accept the symptoms as an inevitable response to menstruation. […] All clinicians, and specifically gynecologists, should proactively inquire about the impact of menstrual-related symptoms on quality of life. […] Evaluating and diagnosing primary dysmenorrhea does not require specialization in women’s health or pelvic pain, and initial complaints frequently are presented to pediatricians and primary care physicians.

• #98 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  Randomized, placebo-controlled trials support the efficacy of NSAIDs in the treatment of primary dysmenorrhea. […] Patients are encouraged to continue first-line therapy for 3 to 6 months, and their response to therapy should be monitored 2 to 3 months after its initiation. […] If adequate relief of symptoms is not achieved, further evaluation or referral to gynecologic specialists is recommended. […] Gynecologists play an important role in building patient and community awareness of the condition, and in its diagnosis and management. […] Progressive worsening of symptoms or suboptimal symptom control with first-line agents warrants further evaluation for secondary causes, including endometriosis.

• #99 Diagnosis and Management of Primary Dysmenorrhea

  https://www.contemporaryobgyn.net/view/diagnosis-and-management-of-primary-dysmenorrhea

  The pelvic exam should be normal in patients with primary dysmenorrhea when not menstruating. […] Transvaginal ultrasonography is the preferred method for the initial evaluation of pelvic organs. […] Although endometriosis is a common cause of secondary dysmenorrhea, routine pelvic ultrasound is frequently unremarkable in affected patients unless there is anatomic distortion, endometrioma, or evidence of deep infiltrative endometriosis. […] Delays in diagnosis and treatment are common and should be avoided. […] The goals of treatment are to provide satisfactory pain and symptom relief and reduce the disturbance in daily activities. […] Therapeutic options should take into account a patient’s contraceptive needs, as both nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives are considered first-line agents, either separately or in combination.

• #100 Period Pain | Menstrual Cramps | MedlinePlus

  https://medlineplus.gov/periodpain.html

  Menstruation, or period, is normal vaginal bleeding that happens as part of a woman’s monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps, which are a throbbing, cramping pain in your lower abdomen. […] To diagnose severe period pain, your health care provider will ask you about your medical history and do a pelvic exam. You may also have an ultrasound or other imaging test. If your health care provider thinks you have secondary dysmenorrhea, you might have laparoscopy. It is a surgery that that lets your health care provider look inside your body. […] If your period pain is primary dysmenorrhea and you need medical treatment, your health care provider might suggest using hormonal birth control, such as the pill, patch, ring, or IUD. Another treatment option might be prescription pain relievers. […] If you have secondary dysmenorrhea, your treatment depends upon the condition that is causing the problem. In some cases, you may need surgery.

Zobacz więcej