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Dysmenorrhea in young people: Experiences from a tertiary center with a focus on conservative management
Author(s) -
Sachedina Aalia,
ABU Bakar Mardiha,
Dunford Angela M.,
Morris Amanda,
NUR Azurah Abdul Ghani,
Grover Sonia R.
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14532
Subject(s) - medicine , endometriosis , pelvic pain , retrospective cohort study , cohort , psychological intervention , medical record , pill , laparoscopy , tranexamic acid , young adult , obstetrics , pediatrics , gynecology , surgery , blood loss , psychiatry , pharmacology
Aim To describe the characteristics, management and outcomes of a cohort of young people with dysmenorrhea presenting to a tertiary adolescent gynecology service, managed primarily with medical interventions. Methods A retrospective cohort study was conducted at the Royal Children's Hospital in Melbourne, Australia. Data were collected from medical records of patients presenting with dysmenorrhea and/or pelvic pain. Results Of 154 patients, mean age of presentation was 15.7 years (SD = 2.2) and mean duration of pain was 14.9 months (SD = 10.8). Regular cycles were reported by 64.5%, and heavy menstrual bleeding (HMB) in 67.8%. Patients self‐reporting HMB reported less pain on the day prior to menses than those not reporting HMB ( P < 0.005). At follow‐up, therapeutic interventions included nonsteroidal anti‐inflammatory drugs, tranexamic acid and cyclic or continuous combined oral contraceptive pills. Laparoscopies were undertaken in 12 (8.1%) patients, with normal findings in 8 (66.7%). Secondary dysmenorrhea was identified in 10 patients: of these, endometriosis was identified in one patient and unilateral obstructive Müllerian anomalies in six. Overall, 92.2% of patients had improvement in symptoms after treatment. Conclusion Laparoscopy and endometriosis rates in patients presenting to a tertiary center were lower than previously reported, with most patients achieving symptom improvement without laparoscopy.