{"id":2606,"date":"2020-08-13T16:08:04","date_gmt":"2020-08-13T16:08:04","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=188"},"modified":"2021-05-09T20:50:13","modified_gmt":"2021-05-09T20:50:13","slug":"46-dysmenorrhea","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/pa_obgyn\/overview\/46-dysmenorrhea\/","title":{"rendered":"46. Dysmenorrhea"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/I79XMHIa1KQ\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Duration = 3:24<\/p>\n<input type='hidden' bg_collapse_expand='69e9b5a49a4ce4038115060' value='69e9b5a49a4ce4038115060'><input type='hidden' id='bg-show-more-text-69e9b5a49a4ce4038115060' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9b5a49a4ce4038115060' value='Hide Transcript'><button id='bg-showmore-action-69e9b5a49a4ce4038115060' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9b5a49a4ce4038115060' ><\/p>\n<p>00:00<br \/>\nAPGO educational topic number 46<br \/>\n00:02<br \/>\ndysmenorrhea meet Aunt Flo she is a<br \/>\n00:05<br \/>\npopular euphemism that refers to a<br \/>\n00:07<br \/>\nwoman&#8217;s menstrual cycle in this video we<br \/>\n00:10<br \/>\nwill discuss what happens when Aunt Flo<br \/>\n00:12<br \/>\nturns painful the objectives of this<br \/>\n00:14<br \/>\nvideo are to define dysmenorrhea and<br \/>\n00:16<br \/>\ndistinguish primary from secondary<br \/>\n00:18<br \/>\ndysmenorrhea describe the<br \/>\n00:20<br \/>\npathophysiology and identify the<br \/>\n00:22<br \/>\nideologies of dysmenorrhea discuss the<br \/>\n00:25<br \/>\nsteps in the evaluation and management<br \/>\n00:26<br \/>\nof dysmenorrhea dysmenorrhea is defined<br \/>\n00:30<br \/>\nas painful menstruation it can be severe<br \/>\n00:32<br \/>\nenough to prevent a woman from<br \/>\n00:34<br \/>\nperforming normal activities and it can<br \/>\n00:36<br \/>\nbe accompanied by diarrhea nausea<br \/>\n00:37<br \/>\nvomiting headache and dizziness primary<br \/>\n00:41<br \/>\ndysmenorrhea has no clinically<br \/>\n00:42<br \/>\nidentifiable cause so here is Aunt Flo<br \/>\n00:44<br \/>\nwith a molotov cocktail of<br \/>\n00:46<br \/>\nprostaglandins secondary dysmenorrhea on<br \/>\n00:49<br \/>\nthe other hand does have a clinically<br \/>\n00:50<br \/>\nidentifiable cause so here is an<br \/>\n00:52<br \/>\nendometriosis cop handcuffing on Flo<br \/>\n00:55<br \/>\nprimary dysmenorrhea is thought to be<br \/>\n00:57<br \/>\nsecondary to excess production of<br \/>\n00:59<br \/>\nprostaglandins which leads to painful<br \/>\n01:01<br \/>\nuterine muscle activity<br \/>\n01:03<br \/>\nthe greatest incidence is in women in<br \/>\n01:06<br \/>\ntheir late teens and early 20s let&#8217;s<br \/>\n01:08<br \/>\nspend a moment to discuss the<br \/>\n01:10<br \/>\npathophysiology of primary dysmenorrhea<br \/>\n01:13<br \/>\nprostaglandins are smooth muscle<br \/>\n01:14<br \/>\nstimulants<br \/>\n01:16<br \/>\nprostaglandin f2 alpha is produced in<br \/>\n01:18<br \/>\nthe endometrium progesterone increases<br \/>\n01:20<br \/>\nproduction of prostaglandin f2 alpha and<br \/>\n01:23<br \/>\ndon&#8217;t forget that progesterone levels<br \/>\n01:25<br \/>\npeak ad or soon before the start of<br \/>\n01:27<br \/>\nmenstruation secondary dysmenorrhea has<br \/>\n01:30<br \/>\na clinically identifiable cause it is<br \/>\n01:33<br \/>\nmore common as a woman ages because it<br \/>\n01:35<br \/>\naccompanies the rising prevalence of<br \/>\n01:36<br \/>\ncausal factors common causes include<br \/>\n01:39<br \/>\nendometriosis adenomyosis pelvic<br \/>\n01:42<br \/>\ninflammatory disease and leiomyoma too<br \/>\n01:44<br \/>\nlet&#8217;s now move to evaluation and<br \/>\n01:46<br \/>\nmanagement take a careful history find<br \/>\n01:50<br \/>\nout if it&#8217;s lower abdominal or super<br \/>\n01:52<br \/>\npubic area if there is fatigue low back<br \/>\n01:54<br \/>\npain or headache which are common and<br \/>\n01:56<br \/>\nascertain how much the pain is<br \/>\n01:58<br \/>\ninterfering with our daily activities<br \/>\n02:00<br \/>\nsuch as school work or sports on<br \/>\n02:02<br \/>\nphysical examination look for any clues<br \/>\n02:05<br \/>\nfor clinically identifiable causes of<br \/>\n02:07<br \/>\nsecondary dysmenorrhea irregular<br \/>\n02:10<br \/>\nenlargement of the uterus suggest<br \/>\n02:11<br \/>\nfibroids and enlarged boggy uterus<br \/>\n02:13<br \/>\nsuggest adenomyosis painful uterus<br \/>\n02:16<br \/>\nsacral nodules or restricted motion of<br \/>\n02:18<br \/>\nthe uterus suggest endometriosis also<br \/>\n02:21<br \/>\nremember to screen for gonorrhea and<br \/>\n02:22<br \/>\nchlamydia to evaluate for infection<br \/>\n02:24<br \/>\nlet&#8217;s now move on to management one of<br \/>\n02:27<br \/>\nthe first-line treatments is<br \/>\n02:29<br \/>\nnon-steroidal anti-inflammatory drugs<br \/>\n02:31<br \/>\nfor these are prostaglandin synthase<br \/>\n02:32<br \/>\ninhibitors other management options<br \/>\n02:35<br \/>\ninclude heat such as heating pads<br \/>\n02:37<br \/>\nexercise psychotherapy and reassurances<br \/>\n02:40<br \/>\noral contraception is effective for it<br \/>\n02:43<br \/>\nsuppresses ovulation and the stabilizes<br \/>\n02:45<br \/>\nestrogen and progesterone levels with<br \/>\n02:48<br \/>\nthe resulting decrease in endometrial<br \/>\n02:49<br \/>\nprostaglandin production the therapy for<br \/>\n02:52<br \/>\nsecondary dysmenorrhea is similar to the<br \/>\n02:54<br \/>\ntherapy for primary dysmenorrhea with<br \/>\n02:56<br \/>\nprimarily symptomatic therapy and if<br \/>\n02:58<br \/>\npossible therapy should be directed at<br \/>\n03:00<br \/>\nthe underlying condition this concludes<br \/>\n03:03<br \/>\nthe aapko video on dysmenorrhea we have<br \/>\n03:05<br \/>\ndefined primary and secondary<br \/>\n03:06<br \/>\ndysmenorrhea discuss pathophysiology and<br \/>\n03:09<br \/>\ndiscuss steps in the evaluation and<br \/>\n03:11<br \/>\nmanagement of dysmenorrhea<br \/>\n03:20<br \/>\nyou<\/p>\n<p><\/div>\n<hr \/>\n","protected":false},"excerpt":{"rendered":"<p>Duration = 3:24<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":46,"menu_order":46,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2606","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2606","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/comments?post=2606"}],"version-history":[{"count":1,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2606\/revisions"}],"predecessor-version":[{"id":2851,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2606\/revisions\/2851"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/46"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/media?parent=2606"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}