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Primary dysmenorrhea in adolescents

Author
Chantay Banikarim, MD, MPH
Section Editors
Mitchell E Geffner, MD
Diane Blake, MD
Deputy Editor
Alison G Hoppin, MD

INTRODUCTION

Primary dysmenorrhea refers to recurrent, crampy lower abdominal pain that occurs during menstruation in the absence of pelvic pathology. It is the most common gynecologic complaint among adolescent females. Secondary dysmenorrhea refers to painful menstruation in the presence of pelvic pathology. It is more common among women in the fourth and fifth decades of life.

The diagnosis and treatment of primary dysmenorrhea in adolescents will be discussed in this topic review. Treatment of primary dysmenorrhea in adult women is reviewed separately. (See "Treatment of primary dysmenorrhea in adult women".)

CLINICAL MANIFESTATIONS

Nausea, vomiting, diarrhea, headache, dizziness, or back pain may accompany the crampy abdominal pain. The pain and associated symptoms typically begin several hours prior to the onset of menstruation and continue for one to three days. The severity of the disorder can be categorized by a grading system based upon the degree of menstrual pain, presence of systemic symptoms, and impact on daily activities (table 1) [1].

EPIDEMIOLOGY

Dysmenorrhea generally does not occur until ovulatory menstrual cycles are established. Maturation of the hypothalamic-pituitary-gonadal axis leading to ovulation occurs at different rates; approximately 18 to 45 percent of teens have ovulatory cycles two years postmenarche, 45 to 70 percent by two to four years, and 80 percent by four to five years [2]. Dysmenorrhea occasionally accompanies anovulatory cycles, especially if heavy bleeding and clots are present. (See "Physiology of the normal menstrual cycle".)

The prevalence of dysmenorrhea among adolescent females ranges from 60 to 93 percent [3-6]. Many adolescents report limitations on daily activities, such as missing school, sporting events, and other social activities because of dysmenorrhea [4-7]. However, only 15 percent of females seek medical advice for menstrual pain, signifying the importance of screening all adolescent females for dysmenorrhea [5].

               

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Literature review current through: Nov 2016. | This topic last updated: Tue Nov 10 00:00:00 GMT 2015.
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References
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