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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Clinical history in an adolescent with dysmenorrhea

Clinical history in an adolescent with dysmenorrhea
Information Clinical significance
Menstrual history
Age at menarche Regular menses (2 to 7 days of bleeding at intervals of 21 to 45 days) suggest ovulatory cycles.
Duration of menstrual cycles
Interval between menstrual periods*
Date of last 2 menstrual periods
Symptom history
Initial onset of symptoms and progression over time
  • Primary dysmenorrhea is usually associated with ovulatory menstrual cycles. Most adolescents have anovulatory cycles for a few months to several years after menarche.
  • Acute onset of crampy pelvic pain and uterine bleeding suggests secondary cause, such as miscarriage or ectopic pregnancy (refer to UpToDate topic on evaluation of acute pelvic pain).
Relation of symptoms to periods Symptoms of primary dysmenorrhea typically begin several hours prior to the onset of menstruation and continue for 1 to 3 days.
Presence or absence of nausea, vomiting, diarrhea, dizziness, fatigue, or headache during menstruation These systemic symptoms are consistent with severe dysmenorrhea.
Impact of symptoms on daily activities such as school attendance, sports participation, and other activities Clear inhibition of activities suggests severe dysmenorrhea or other pathology.
Medication use and perceived effects Lack of relief from analgesics suggests severe dysmenorrhea or other pathology.
Sexual history
Current sexual activity and type of contraception For sexually active females, hormonal contraceptives are a reasonable first-line choice for treatment of dysmenorrhea.
History of sexually transmitted diseases and history of pelvic inflammatory disease Known or suspected pelvic inflammatory disease may be associated with secondary dysmenorrhea.

* The interval between menstrual periods is measured from the first day of 1 period to the first day of the next period.

¶ Medication type, dose, and timing in relation to the onset of cramps; perceived effectiveness for pain relief and ability to engage in all daily activities.
Graphic 112839 Version 5.0

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