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Dysmenorrhoea - Management
Common causes of secondary dysmenorrhoea
- Common causes of secondary dysmenorrhoea include:
- Endometriosis — cyclical or chronic pelvic pain, that frequently occurs prior to menstruation and may be accompanied by heavy menstrual bleeding and deep dyspareunia.
- Adenomyosis — painful menstruation, that may be accompanied by heavy menstrual bleeding.
- Fibroids (myomas) — lower abdominal pain, frequently accompanied by menorrhagia; a pelvic mass may be identified on examination.
- Endometrial polyps — more common in women older than 50 years of age. Abnormal vaginal bleeding may occur.
- Pelvic inflammatory disease — lower abdominal pain and tenderness that may be accompanied by dyspareunia, abnormal vaginal bleeding, and abnormal vaginal discharge. In acute infection, fever may be present.
- Intrauterine device (IUD) — a history of IUD insertion, usually 3–6 months previously. Pain may be accompanied by longer and heavier periods, often with bleeding or spotting in between periods.
[BASHH, 2005; Society of Obstetricians and Gynaecologists of Canada, 2005; Proctor and Farquhar, 2006]
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