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Snap Shot
  • An 18-year-old nulligravid college woman complains of painful menses for the past three years. These symptoms are associated with cramping located in her lower abdomen that radiate to her lower back and inner thighs. She has nausea and vomiting. Pelvic exam is normal.
Introduction
  • Abdominal pain with menses
  • May result from primary or secondary causes
    • primary
      •  excessive prostaglandin-induced myometrial contractions
        • ↑ PGF
    • secondary
      • endometriosis
      • adenomyosis
      • leiomyomas
Treatment
  • Medical (for primary type)
    • ibuprofen/NSAID
    • OCP
    • nifedipine
 

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