Dysmenorrhea in adolescents
Dysmenorrhea in adolescents
复制标题
DOI：
10.1196/annals.1429.007
复制
发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Harel, Zeev
中科院分区：
文献类型：
--
作者：
Harel, Zeev
痛经是青春期女性最常见的妇科疾病。青少年痛经通常是原发性的，与正常的排卵周期有关，并且没有盆腔病变。在大约10%有严重痛经症状的青少年中，可能会发现盆腔异常，如子宫内膜异位症或子宫异常。有效的甘草素和白三烯在产生痛经症状中起重要作用。非甾体抗炎药（NSAID）是痛经最常见的药物治疗。负荷剂量的NSAID（通常是常规剂量的两倍）应作为青少年痛经的初始治疗，然后是常规剂量，直到症状减轻。对NSAID治疗三个月经周期无反应的症状的青少年应提供激素治疗，如三个月经周期的雌激素/炔雌醇联合口服避孕药。对这种治疗无效的青少年痛经患者应评估继发性痛经原因。青少年保健提供者的作用是向每一位青少年女性解释痛经的病理生理学，解决患者对月经期的任何担忧，并与患者一起审查痛经的有效治疗方案。
Dysmenorrhea is the most common gynecologic complaint among adolescent females. Dysmenorrhea in adolescents is usually primary, and is associated with normal ovulatory cycles and with no pelvic pathology. In approximately 10% of adolescents with severe dysmenorrheic symptoms, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins and leukotrienes play an important role in generating the symptoms of dysmenorrhea. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common pharmacologic treatment for dysmenorrhea. A loading dose of NSAIDs (typically twice the regular dose) should be used as initial treatment for dysmenorrhea in adolescents, followed by a regular dose until symptoms abate. Adolescents with symptoms that do not respond to treatment with NSAIDs for three menstrual periods should be offered hormonal treatment such as combined estrogen/progestin oral contraceptive pills for three menstrual cycles. Adolescents with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The adolescent care provider's role is to explain the pathophysiology of dysmenorrhea to every adolescent female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.