b. primary dysmenorrhea
Darlene is a 15-year-old female who comes to the clinic with her mother. She reports having
severe headache and pain with her menstrual period. The pain is interfering with her ability to
attend school and participate in softball and tennis.
Which disorder does this patient have?
a. precocious puberty
b. primary dysmenorrhea
c. secondary amenorrhea
d. primary amenorrhea
menorrhea
menstrual bleeding
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precocious puberty
the premature development of sexual characteristics due to premature functioning of the
hypothalamic-pituitary-ovarian axis?
primary amenorrhea
the lack of menstrual cycle by the age of 14
,secondary amenorrhea
the lack of menstruation in women for more than 3 cycles who have previously menstruated
- can be a normal physiologic process: pregnancy, menopause
pregnancy and menopause
in what physiologic processes is secondary amenorrhea considered normal?
primary dysmenorrhea
painful menstruation in young women between the ages of 15 and 25 years old
menarche
the first menstrual period
8 - 72 hours
what is the duration of primary dysnmenorrhea?
prior to onset of menses and throughout menstrual cycle
what is the time frame of pain with secondary dysmenorrhea?
16-25 years
what is the age group for primary dysmenorrhea?
30-45 years
what is the age group for secondary dysmenorrhea?
false, primary dysmenorrhea occurs with menarche (the first bleeding)
* secondary dysmenorrhea occurs after menarche
T/F: primary dysmenorrhea is common in women after menarche.
true
T/F: Secondary dysmenorrhea is usually co-existent with other gynecological problems such as
PCOS and PID.
a. excessive endometrial prostaglandin F (PGF2α)
, - PGs increase myometrial contractions
[no indication of inflammation: no WBC count; uterine fibroids not common in young females]
What is the probable cause of Darlene's disorder (primary dysmenorrhea)?
a. excessive endometrial prostaglandin F (PGF2α) production
b. pelvic adhesions
c. inflammatory disease
d. uterine fibroids
prostaglandins
Primary dysmenorrhea is a disorder caused by excessive ______ found in secretory
endometrium.
prostaglandins (PG2Fα)
which hormones increase myometrial contractions and constrict endometrial blood vessels,
causing ischemia, increased nerve sensitivity, and endometrial shredding? [may also cause GI
issues, headaches, and syncope]
c. calcium supplements
- Ca2+ will augment contractions of the endometrium, leading to more pain
[NSAIDs provide pain relief by inhibiting prostaglandin synthesis, decreasing inflammation;
relaxation techniques such as yoga or meditation reduce symptoms by causing smooth muscle
relaxation of the uterus]
Which one of the choices listed below would NOT be the best approach to reducing Darlene's
symptoms of primary dysmenorrhea?
a. non-steroidal anti-inflammatory medications
b. hormonal contraceptives
c. calcium supplements
d. relaxation techniques
oral contraceptives
which class of medications would be an option for treating primary dysmenorrhea in a
15-year-old female due to its ability to produce cessation of ovulation and thin the endometrium
(atrophic endometrium), which decreases prostaglandin synthesis and myometrial contractility?
follicular phase
The first phase of the ovarian cycle, during which a follicle (an oocyte and its surrounding cells)
enlarges and matures. This phase is under the control of FSH from the anterior pituitary, and