Primary dysmenorrhea in adolescents
- Chantay Banikarim, MD, MPH
Chantay Banikarim, MD, MPH
- Director of Adolescent Medicine
- St. Joseph's Hospital & Medical Center, Phoenix
- Section Editors
- Mitchell E Geffner, MD
Mitchell E Geffner, MD
- Section Editor — Pediatric Endocrinology
- Professor of Pediatrics
- Keck School of Medicine, University of Southern California
- Diane Blake, MD
Diane Blake, MD
- Section Editor — Adolescent Medicine
- Professor of Pediatrics
- University of Massachusetts Medical School
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. Management is directed toward excluding pelvic pathology (secondary dysmenorrhea) and selecting medication appropriate to the patient's individual characteristics and symptom severity.
The diagnosis and treatment of primary dysmenorrhea in adolescents will be discussed in this topic review. Evaluation and treatment of primary dysmenorrhea in adult women is reviewed separately. (See "Primary dysmenorrhea in adult women: Clinical features and diagnosis" and "Treatment of primary dysmenorrhea in adult women".)
For clinical purposes, dysmenorrhea is divided into two broad categories:
●Primary dysmenorrhea refers to the presence of recurrent, crampy, lower abdominal pain that occurs during menses in the absence of demonstrable disease that could account for these symptoms.
●Secondary dysmenorrhea has the same clinical features but occurs in women with a disorder that could account for their symptoms, such as endometriosis (table 2B). Secondary dysmenorrhea is more common among women in the fourth and fifth decades of life, but occasionally occurs in adolescents.
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- CLINICAL MANIFESTATIONS
- Physical examination
- Differential diagnosis
- Nonsteroidal antiinflammatory drugs (NSAIDs)
- Oral contraceptives (OCs)
- Treatment failure
- OTHER INTERVENTIONS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS