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Dysmenorrhea: contemporary perspectives. Obstet Gynecol Surv 2008 Sep;63(9):597-603 PMID: 18713479

Pubmed ID

18713479

Abstract

Dysmenorrhea affects up to 80% of reproductive age women, in many cases causing sufficient pain to dramatically affect social and occupational roles. The prevalence varies across ethnic groups, which in part may reflect varying cultural attitudes toward women and menstruation. Key identified risk factors for dysmenorrhea include age of menarche, body mass, dietary habits, associated uterine bleeding disorders, comorbid pelvic pathology, and psychosocial problems. While much of the focus on the pathogenesis of dysmenorrhea has focused on aberrant inflammatory mediators in the uterine environment, recent studies using experimental quantitative sensory testing suggest central processing of pain is enhanced in many of these women as well, similar to both irritable bowel syndrome and painful bladder syndrome, which are closely related visceral pain disorders. The mainstays of treatment include nonsteroidal antiinflammatories and combined oral contraceptives; although only the former has extensive level I evidence to support its efficacy. Surgical treatments (presacral neurectomy or uterosacral nerve ablation) appear to be beneficial in a subset of women, but are associated with small, but serious, risks of visceral or vascular injury. Complementary and alternative treatments such as vitamin B1 and magnesium supplementation have not been studied as extensively but show some promise as well. In particular, treatments targeting central aberrations in pain processing, as used in chronic pain management, may prove beneficial as a more multidimensional approach to this common malady is accepted in our field.

Author List

Bettendorf B, Shay S, Tu F

Author

Sophie G. Shay MD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin




Scopus

2-s2.0-59649124364   28 Citations

MESH terms used to index this publication - Major topics in bold

Dysmenorrhea
Female
Humans
Prevalence
Risk Factors
jenkins-FCD Prod-271 16cb5dcaa6d2cfe4986875aea432578e3ad30554