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Assessment of dysmenorrhoea

Authoring team

  • full gynaecological history - with special attention to:
    • onset of dysmenorrhoea and relation to menses
    • intra-uterine contraceptive device - present ?
    • dyspareunia, menorrhagia, or infertility ?

  • general examination - including:
    • bimanual pelvic examination / speculum examination
    • look for polyps protruding through the cervical os and for enlargement, tenderness or fixity of the uterus or adnexa

  • specialised investigations:
    • laparoscopy
    • dilatation and curettage
    • hysteroscopy - to reveal endometrial polyps or submucous leiomyomas which may be missed on curettage; diagnostic hysteroscopy is often performed as an outpatient procedure

Reference

  1. Kho KA, Shields JK. Diagnosis and Management of Primary Dysmenorrhea. JAMA. 2020 Jan 21;323(3):268-269.

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