What it is
Amenorrhea
The absence of menstrual
flow criteria: Absence of
sex characteristics and
menarche by 13. The
absence of menses by age
15 or the absence of
menstruation within 5
years of breast
development
Pain during or shortly
before period
Primary
Dysmenorrhea
Secondary
Dysmenorrhea
Premenstrual
Syndrome (PMS)
Menstrual pain that
develops later in life.
Typically, after 25 years of
age.
Many physical and
psychological symptoms
beginning in the luteal
phase
Causes & risk
factors
Obesity
Malnutrition
Strenuous
exercise
Anatomic
abnormalities
Drugs and
alcohol
Risks; smoking,
obesity
excessive
release of
prostaglandins
Symptoms
No menstruation or delayed
pain begins at onset of
menstruation and lasts 12-72
hours backache, weakness,
sweats, gastrointestinal
symptoms, and CNS symptoms
(dizziness, syncope, headache,
and poor concentration).
Appears 6-12 months after
menarche when ovulation is
established
Adenomyosis, Heavy menstrual flow, dull
endometriosis, lower-abdominal aching that
PID,
radiates to the thighs,
endometrial
bloating, pelvic fullness
polyps,
fibroids
biologic,
fluid retention (abdominal
psychosocial,
bloating, pelvic fullness,
and
edema of the lower
sociocultural
extremities, breast
factors
tenderness, and weight gain),
behavioral or emotional
changes
Interventions & treatments
Assess stress
Decrease intensity of exercise
Oral contraceptives
Heat
Aerobic exercise
TENS
Lamaze
Decrease intake of salt and
refined sugar 7-10 days before
period. Low-fat diet and
vitamin E
NSAIDs
Combined OCPs
Aimed at removing underlying
pathology
Pain relief
Diet changes
Exercise
Calcium
Vitamin B
OCP
SSRI
Premenstrual more severe variant of PMS biologic,
Dysphoric
psychosocial,
Disorder (PMDD).
and
sociocultural
factors
Endometriosis Presence and growth of
endometrial tissue outside
of the uterus
marked irritability, dysphoria,
mood lability, anxiety, fatigue,
appetite changes, and a sense
of feeling overwhelmed
Same as PMS
pelvic pain, dysmenorrhea,
and dyspareunia (painful
intercourse). Women may also
have chronic noncyclic pelvic
pain, pelvic heaviness, or pain
radiating into the thighs. Many
women report bowel
symptoms such as diarrhea,
pain with defecation, and
constipation caused by
avoiding defecation because
of the pain.
GnRH agonists
androgen derivatives
androgenic synthetic steroid
total abdominal hysterectomy
(TAH) with bilateral
salpingectomy and
oophorectomy (BSO)
laser therapy