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Primary Dysmenorrhea

Epidemiology
1. Begins within 2 years (usually <12 months) of Menarche
Pathophysiology
1. Uterine hyperactivity
  1. Increased myometrial resting tone >10 mmHg
  2. Increased contractile myometrial prEssure >120 mmHg
  3. Increased frequency of uterine contractions
  4. Dysrhythmia of uterine contractions
2. Increase in enzyme Prostaglandin Synthetase
3. Increased prostaglandins result in vasoconstriction
4. Uterine Hypoxia (uterine Angina)
Symptoms
1. See Dysmenorrhea
Management
1. Nonsteroidal Anti-inflammatory drugs (NSAIDS)
  1. Ibuprofen (Motrin) 400 to 800 mg PO tid to qid
  2. Naproxen (Naprosyn) 500 mg PO bid
  3. Mefenamic acid (Ponstel) 500 mg PO tid
2. Oral Contraceptives
3. Calcium Channel Blocker

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This page was written by Scott Moses, MD, and was last revised 1/13/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.