Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives.
Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives.
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DOI：
10.1016/s1083-3188(00)00076-0
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发表时间：
2001-02-01
影响因子：
1.8
通讯作者：
Westhoff, C L
中科院分区：
文献类型：
--
作者：
Davis, A R;Westhoff, C L
这篇综述考察了青春期女孩的原发性痛经的患病率、相关发病率和治疗方法。使用MEDLINE和Cochrane协作数据库对相关文献进行系统的循证审查。痛经在青春期非常普遍。尽管测量方法不同，20%-90%的青春期女孩报告痛经，约15%的青少年称她们的痛经严重。在青春期，痛经会导致高缺勤率和不参与活动。大多数患有痛经的青少年会自行服用非处方药；很少有人咨询医疗保健提供者。联合口服避孕药(COC)是治疗非青春期女性痛经的公认疗法。然而，支持COC疗效的数据是有限的。非常小的研究表明，月经液中前列腺素的减少与高剂量的COC使用有关。较大的研究仅限于横断面比较，显示低剂量COC使用者与非COC使用者相比痛经发生率较低。一项包括一些青少年的小型随机对照试验显示，与安慰剂相比，大剂量COC治疗可以改善痛经。小剂量COC治疗青春期痛经的疗效尚未确定。如果有效，公认的安全性和非避孕健康益处可能使COC成为治疗青春期女孩痛经的理想药物。
This review examines the prevalence, associated morbidity, and treatment of primary dysmenorrhea in adolescent girls. Relevant literature was examined by systematic, evidence-based review using MEDLINE and Cochrane Collaboration databases. Dysmenorrhea is highly prevalent during adolescence. Despite differences in measurement methods, 20%-90% of adolescent girls report dysmenorrhea and about 15% of adolescents describe their dysmenorrhea as severe. During adolescence, dysmenorrhea leads to high rates of school absence and activity nonparticipation. Most adolescents with dysmenorrhea self-medicate with over-the-counter preparations; few consult healthcare providers. Combined oral contraceptives (COC) are an accepted treatment for dysmenorrhea in nonadolescent women. However, data supporting the efficacy of COC is limited. Very small studies show decreased prostaglandin in menstrual fluid associated with high-dose COC use. Larger studies are limited to cross-sectional comparisons showing lower prevalence of dysmenorrhea in low-dose COC users compared to non-COC users. One small, randomized controlled trial including some adolescents demonstrated an improvement in dysmenorrhea with high-dose COC treatment compared to placebo. The efficacy of low-dose COC in the treatment of adolescent dysmenorrhea has yet to be determined. If effective, well-established safety and noncontraceptive health benefits may make COC an ideal treatment for dysmenorrhea in adolescent girls.