Hopp til hovedinnhold

Primær dysmenoré

Sist oppdatert: Sist revidert:
Sist revidert av:

Definisjon:
Menstruasjonssmerter uten ledsagende patologiske funn. Skyldes vedvarende uterin vasokonstriksjon utløst av prostaglandiner som medfører hypoksi i uterinmuskulaturen
Forekomst:
Svært utbredt blant unge jenter, forbedres ofte med tiden
Symptomer:
Krampelignende smerter i abdomen, lysker, korsrygg og innsiden av lårene, ev. kvalme, brekninger, diaré. Starter noen timer før blødningen setter inn, avtar vanligvis etter et døgn
Funn:
Normal klinisk status
Diagnostikk:
Ingen tilleggsundersøkelser er vanligvis påkrevd
Behandling:
NSAIDs eller p-piller
  1. Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014 Mar 1;89(5):341-346. PubMed  
  2. Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ 2006; 332: 1134-8. PubMed  
  3. Davis AR, Westhoff CL. Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives. J Pediatr Adolesc Gynecol 2001; 14: 3-8. PubMed  
  4. Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;6:177. PubMed  
  5. Moen MH, Stokstad T. A long-term follow-up study of women with asymptomatic endometriosis diagnosed incidentally at sterilization. Fertil Steril 2002; 78: 773-6. PubMed  
  6. Momoeda M, Taketani Y, Terakawa N, Hoshiai H, Tanaka K, Tsutsumi O, et al. Is endometriosis really associated with pain? Gynecol Obstet Invest 2002; 54(suppl 1): 18-21.
  7. Latthe P, Mignini L, Gray R, et al. Factors predisposing women to chronic pelvic pain: systematic review. BMJ 2006; 332: 749. pmid:16484239 PubMed  
  8. Marjoribanks J, Ayeleke RO, Farquhar C, et al. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015 Jul 30;7:CD001751. Cochrane (DOI)  
  9. Moore J, Copley S, Morris J, Lindsell D, Golding S, Kennedy S. A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis. Ultrasound Obstet Gynecol 2002; 20: 630-4. PubMed  
  10. Matthewman G, Lee A, Kaur JG, Daley AJ. Physical activity for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol 2018; 219: 255. pmid:29630882 PubMed  
  11. Armour M, Ee CC, Naidoo D, et al. Exercise for dysmenorrhoea. Cochrane Database Syst Rev. 2019 Sep 20;9:CD004142. doi: 10.1002/14651858.CD004142.pub4. DOI  
  12. Pattanittum P, Kunyanone N, Brown J, et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev 2016; 3: CD002124. doi:10.1002/14651858.CD002124.pub2 DOI  
  13. Zhu X, Proctor M, Bensoussan A, et al. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev. 2008; 16: CD005288. pmid:18425916 PubMed  
  14. Hendrix SL, Alexander NJ. Primary dysmenorrhea treatment with a desogestrel-containing low-dose oral contraceptive. Contraception 2002; 66: 393-9. PubMed  
  15. Wong CL, Farquhar C, Roberts H, et al. Oral contraceptive pill treatment for primary dysmenorrhoea. Cochrane Database Syst Rev 2009; 15: CD002120. Cochrane (DOI)  
  16. Kvan E, Narum S. P-piller med forlenget syklus - et fremskritt?. Tidsskr Nor Lægeforen 2005; 125: 2202-3. Tidsskrift for Den norske legeforening  
  17. Earl RA, Grivell RM. Nifedipine for primary dysmenorrhoea. Cochrane Database of Systematic Reviews 2021, Issue 12. Art. No.: CD012912. DOI: 10.1002/14651858.CD012912.pub2. Accessed 03 January 2022. The Cochrane Library  
  18. Baldaszti E, Wimmer-Puchinger B, Loschke K. Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena): a 3-year follow-up study. Contraception 2003; 67: 87-91. PubMed  
  19. Proctor M, Farquhar C, Stones W, He L, Zhu X, Brown J. Transcutaneous electrical nerve stimulation for primary dysmenorrhoea. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD002123. DOI: 10.1002/14651858.CD002123. DOI  
  20. Proctor ML, Latthe PM, Farquhar CM, et al. Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2005; 4: CD001896. pmid:16235288 PubMed  
  21. Smith CA, Armour M, Zhu X, et al. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016 Apr 18;4:CD007854. PMID: 27087494 PubMed  
  22. Proctor M, Hing W, Johnson TC, Murphy PA, Brown J. Spinal manipulation for dysmenorrhoea. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD002119. DOI: 10.1002/14651858.CD002119.pub3. DOI  
  23. Akin MD, Weingand KW, Hengehold DA, Goodale MB, Hinkle RT, Smith RP. Continuous low-level topical heat in the treatment of dysmenorrhea. Obstet Gynecol 2001; 97: 343-9. PubMed  
  24. Akin M, Price W, Rodriguez G Jr, Erasala G, Hurley G, Smith RP. Continuous, low-level, topical heat wrap therapy as compared to acetaminophen for primary dysmenorrhea. J Reproductive Med 2004; 49: 739-45. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Per Bergsjø, professor emeritus, dr. med., Universitetet i Bergen. Spesialist i kvinnesykdommer og fødselshjelp, forsker ved Nasjonalt folkehelseinstitutt, Oslo
  • Ellen Løkkegaard, overlæge, ph.d., klinisk lektor, Gynækologisk-obst. afd., Nordsjællands Hospital Hillerød