Dysmenorrhea and Endometriosis: Diagnosis and Management in Adolescents : Clinical Obstetrics and Gynecology

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Pediatric and Adolescent Gynecology: What the Generalist Ob/Gyn Needs to Know

Dysmenorrhea and Endometriosis: Diagnosis and Management in Adolescents


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Clinical Obstetrics and Gynecology 63(3):p 536-543, September 2020. | DOI: 10.1097/GRF.0000000000000540


Dysmenorrhea is common in adolescents. Most have primary dysmenorrhea and respond to empiric treatment with nonsteroidal anti-inflammatory drugs and/or hormonal therapies. Infrequently, patients have persistent symptoms requiring further evaluation including a pelvic examination, ultrasonography, and/or diagnostic laparoscopy. The most common cause of secondary dysmenorrhea in adolescents is endometriosis. Endometriosis is an estrogen-dependent, inflammatory condition with no surgical or medical cure. Treatment is individualized and typically includes surgical diagnosis with resection and/or ablation limited to visible lesions followed by hormonal suppressive therapy in an attempt to relieve symptoms, limit disease progression, and protect fertility. Multidisciplinary attention to comorbidities and pain management as well as patient education and support are important.

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