Which type of dysmenorrhea has cramping pain staing at the onset of mensus and more pronounced in the first two days of menstruation?
Cramping pain at the onset of mensus and more pronounced in the first two days of menstruation is suggestive of spasmodic dysmenorrhea. Dysmenorrhea is defined as cramping pain accompanying menstruation. It can be classified as: A.Etiological: Primary dysmenorrhoea: This is not associated with any idendifiable pelvic pathology. It affects more than 50% of post-pubescent women in the age group of 18 to 25 years, with ovulatory cycles. Secondary dysmenorrhoea: It is associated with the presence of organic pelvic pathologies such as fibroids, adenomyosis, PID and endometriosis Unilateral dysmenorrhoea can be seen in a rudimentary horn of bicornuate uterus, IUCD users, and cervical stenosis. B. Clinical: Spasmodic dysmenorrhoea: It is the most prevalent and manifests as cramping pain, right before or at the sta of the menstrual period, and is most pronounced on the first and second days of menstruation Congestive dysmenorrhoea: It present as increasing pelvic discomfo and pelvic pain, a few days before menses begin. Thereafter, the patient experiences rapid relief of the symptoms. This variety is commonly seen in PID. IUCD users, varicosities of pelvic vein, pelvic veins, pelvic endometriosis, and fibroids. Membranous dysmenorrhoea: It is a special group, in which the endometrium is shed as a cast at the time of menstruation. The passage of the cast is associated with painful uterine cramps. It is the rarest variety. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 124
Congestive dysmenorrhoea
Spasmodic dysmenorrhoea
Membranous dysmenorrhea
All of the following
Disorders of menstruation