Dysmenorrhea in Emergency Medicine Treatment & Management

  • Author: Andre Holder, MD; Chief Editor: Pamela L Dyne, MD   more...
 
Updated: Apr 15, 2011
 

Prehospital Care

Many women never seek medical attention for dysmenorrhea. Self-medication with analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) as well as direct application of heat are common effective strategies.

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Emergency Department Care

  • As always, ED evaluation should begin with the ABCs and should consider serious diagnoses such as hemorrhagic shock and sepsis.
  • A patient whose history and clinical presentation clearly suggest primary dysmenorrhea may be treated symptomatically and provided with appropriate follow-up.
  • A patient whose presentation is less clear or whose vital signs and/or physical examination findings are abnormal deserves a more thorough workup, including full laboratory studies, pelvic ultrasonography, and potentially an OB/GYN consultation.
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Consultations

Patients with pelvic pain do not routinely need consultation with a gynecologist in the emergency department, though they should be directed to follow up as an outpatient. Exceptions include certain infectious entities, such as abscesses, as well as endometriosis.

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Contributor Information and Disclosures
Author

Andre Holder, MD  Staff Physician, Departments of Emergency Medicine and Internal Medicine, Jacobi Medical Center

Andre Holder, MD, is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and National Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Laurel D Edmundson, MD  Clinical Assistant Instructor of Emergency Medicine, Resident, Department of Emergency Medicine, Kings County Hospital Center, Brooklyn

Laurel D Edmundson, MD is a member of the following medical societies: American Medical Association and Medical Society of the State of New York

Disclosure: Nothing to disclose.

Mert Erogul, MD  Assistant Professor of Emergency Medicine, University Hospital of Brooklyn: Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Mert Erogul, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Steven A Conrad, MD, PhD  Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center

Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Mark Zwanger, MD, MBA  Assistant Professor, Department of Emergency Medicine, Jefferson Medical College of Thomas Jefferson University

Mark Zwanger, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD  Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

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  2. Proctor ML, Murphy PA, Pattison HM, Suckling J, Farquhar CM. Behavioural interventions for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. Jul 18 2007;CD002248. [Medline].

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  16. [Best Evidence] Witt CM, Reinhold T, Brinkhaus B, Roll S, Jena S, Willich SN. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol. Feb 2008;198(2):166.e1-8. [Medline].

  17. Andersch B, Milsom I. An epidemiologic study of young women with dysmenorrhea. Am J Obstet Gynecol. Nov 15 1982;144(6):655-60. [Medline].

  18. Harel Z, Biro FM, Kottenhahn RK, Rosenthal SL. Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents. Am J Obstet Gynecol. Apr 1996;174(4):1335-8. [Medline].

 
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