Dysmenorrhoea

Dysmenorrhoea, or heavy periods, affects many women and can disrupt their work and schooling. Primary dysmenorrhoea occurs in the absence of underlying disease whereas secondary dysmenorrhoea is usually due to underling pathology. Uterine hyperactivity and increased prostaglandin levels are found in primary dysmenorrhoea. Primary dysmenorrhoea is best treated with non-steroidal anti-inflammatory drugs (NSAIDs) or with a combined oral contraceptive pill. Transcutaneous electrical nerve stimulation (TENS) and locally applied heat are also effective. Secondary dysmenorrhoea is treated by finding and treating the associated underlying pathology (e.g. endometriosis, adenomyosis, pelvic inflammatory disease). This will usually require referral to a hospital specialist.