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Dysmenorrhea

from Chief complaints and diagnoses

Published online by Cambridge University Press:  18 December 2009

By
Benjamin A. White  and
Stephen H. Thomas
Edited by
Stephen H. Thomas
Stephen H. Thomas
Affiliation:
Harvard Medical School
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Summary

This chapter addresses relief of abdominal cramping and related symptoms (e.g. pelvic pain, backache) associated with the menstrual cycle. It focuses on analgesic control of dysmenorrhea symptoms, rather than hormonal regulation of the ovulatory cycle. Prostaglandin inhibition by NSAIDs is responsible for their decades of successful use as the mainstay of dysmenorrhea treatment. An RCT in patients undergoing fractional curettage demonstrated the potent analgesic effects of NSAIDs on uterine pain. Due to the need for chronic use, the COX-2 selective NSAIDs are sometimes recommended as a treatment for dysmenorrhea. Data show that valdecoxib, administered in a single dose of 40 mg PO, provides dysmenorrhea pain relief within 30 minutes that lasts for up to 24 hours. The novel analgesic flupirtine is suggested by some to have utility in dysmenorrhea, but this centrally acting agent is not recommended owing to limited evidence and frequent side effects.

Keywords

anxiolyticsbenzodiazepinesburn painlorazepammorphineopioidsthermal burnsmidazolam
Type
Chapter
Information
Emergency Department Analgesia
An Evidence-Based Guide
 , pp. 193 - 196
Publisher: Cambridge University Press
Print publication year: 2008

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