SPECIFIC LEARNING TEACHING

OBJECTIVE TIME CONTENT ACTIVITY METHOD EVALUATIO

2min INTRODUCTION
The condition refers to the pain or discomfort associated with
menstruation although not a serious medical problem, its usually
meant to describe a women with menstrual symptoms severe enough
to keep her from functioning for a day or two each month . the pain is
typically described as dull, aching , cramping and aften radiates to
the lower back.
MEANING
Dysmenorrhea – derived from the Greek meaning difficult monthly
flow
*the word dysmenorrhea has come to mean painful menstruation
Dys = difficult/ pain full/ abnormal
2min Meno = meaning month
Rrhea = meaning flow
A women is considered to have premenstrual syndrome if she
complains of recurrent psychological (or) somatic symptoms (or)
both occurring specifically during the luteal phase of the menstrual
cycle and which resolve in the follicular phase at least by the end of
menstruation.
DEFINITION
-Dysmenorrhea is defined as painful menstruation

- dysmenorrhea is a term describing painful menstruation that

typically involves cramps caused by uterine contractions .
3min
-Abdullah baghaffar

Dysmenorrhea also known as dysmenorrhea, painful periods,

(or)
 menstrual cramps is pain during menstruation
Dysmenorrhea is a term describing painful menstruation that
typically involves cramps caused by uterine contraction
CAUSES
 Excessive production of prostaglandin, thae chemical that
cause the uterus to contact
 Hormonal disorders
 Endometriosis
 Fibroids {benign tumors in the uterus } which the uterus
may try to expel
 IUD [ intra uterine contraceptive device] other foreign body
in the uterus , which may the uterus may try to expel
 Pelvic infection or inflammation
 Disorder s of the reproductive organs {eg ; cysts tumors}
TWO FORMS OF DYSMENORRHEA
Dysmenorrhea is divided into two categories
1, spasmodic [primary dysmenorrhea]
2, secondary dysmenorrhea
SPASMODIC (PRIMARY DYSMENORRHEA):
*Painful menstruation with no identifiable pelvic pathology
*Note: the highest level is in the first 2 days of menses
*primary dysmenorrhea starts from 12 to 24 hour before the onset of
menses.
*abdominal pain aften accompanied by
-nausea
-diarrhea
-fatigue
-headache or dizziness
*Usually begins with a first periods and is heralded by cramping
lower abdominal pain starting just before or with the menstrual flow
and continuing during menstruation . it is often associated with
nausea, vomiting, headache, faintness and symptoms of peripheral
vasodilation. The cause is thought to be related to excessive
prostaglandin production.
CAUSE OF PRIMARY DYSMENORRHEA
Increase prostaglandin
production by the endometrium in an ovulatory cucle which cause
contraction of the uterus
CONGESTIVE (SECONDARY DYSMENORRHEA)
*painful menstruation due to pelvic or uterine pathology.
*secondary dysmenorrhea usually occurs after the women has
experienced problem free periods for sometime.
*pain may be unilateral , constant and continues, longer than primary
dysmenorrhea .
*painful intercourse
*painful defecation
*irregular bleeding may occur at times other than menses
*usually effects older women who complain of a congested ache with
a lower abdominal cramps, which usually starts from a few days to
weeks before menstruation.
CAUSES OF SECONDARY DYSMENORRHEA
-Pelvic inflammatory disease,
- endometriosis
- uterine fibroids and the presence of an IUD.
-adenomyosis
-pelvic infection
-congenital uterine or vaginal anomaly
SIGNS AND SYMPTOMS
 Mild to severe cramps in the lower abdomen, which may
comes and go in waves.
 Dull ache in lower back hips or thighs.
 Headaches
  Dizziness, nausea, and vomitings.
 Hot and cold sensations
 Diarrhea, in some cases
 Fainting in some cases
DIAGNOSIS
o History collection
o Physical examination
o primary dysmenorrhea ; cramping pain with menstruation and
physical examination is completely normal
o secondary dysmenorrhea ; if the signs and symptoms are
findings then further diagnostic evaluation are done
o Pelvic examination
LABORATORY TEST
 Blood test CBC rule out evidence of infection
 Urine analysis to rule out bladder infection
 Cervical culture to exclude STI
 ESR- electrolyte sedimentation rate to detect an
inflammatory process
TREATMENT
 Antiprostaglandin drugs
 Pain relief- NSAIDS, Eg; Naproxen, ibuprofen
 Low doses- of oral contraceptive pills
 Heat application- hot bath
- heat is applied to the lower abdomen or back may reduce
dysmenorrhea
 Place a heating pad on your abdomen
 Exercises-Life style changes like daily exercises
 Gently massaging your abdomen
 Getting plenty of rest and avoiding stressful situation as your
periods approaches.
 Weight loss
  Relaxation techniques; sleep and rest for adequate time
 Avoid unnecessary work load
NURSING DIAGNOSIS
 Pain related to dysmenorrhea
 Activity intolerance related to pain
NURSING INTERVENTION
 Ask client to apply heat eg; warm baths, putting a hot water
bottle or heating pad on the abdomen
 Ask client to drink plenty of fluids, but avoid alcohol
 Ask client to do regular exercise, particularly
aerobics[ cycling, jogging, brisk walking].
COMPLICATION
 Fainting -from severe menstrual cramps
 abdominal pain
 back pain
REFERNCE
http;//www.ask.com
http;//www.wikipedia.com
http;//www.google.com
http;//www.yahoo.com
http;//www.answer.com