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Chapter 49. Menstruation-Related Disorders

Student Questions

In addition to medication therapy, which of the following is best to recommend to a woman presenting with complaints of dysmenorrhea?

A. Exercise

B. Acupuncture

C. Massage therapy

D. Heat therapy

Answer: A

Option A: Correct. Exercise may help reduce dysmenorrhea symptoms by increasing pelvic blood flow and stimulating the release of beta-endorphins which act as analgesics.

Option B: Incorrect. Acupuncture therapy lacks sufficient data to recommend as standard of care.

Option C: Incorrect. Massage therapy lacks sufficient data to recommend as standard of care.

Option D: Incorrect. Heat therapy lacks sufficient data to recommend as standard of care.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy for dysmenorrhea because they do all of the following except:

A. Decrease uterine contractions

B. Exert analgesic properties

C. Decrease endometrial lining

D. Reduce menstrual blood flow

Answer: C

Option A: Incorrect. NSAID therapy does decrease uterine contractions.

Option B: Incorrect. NSAID therapy does help exert analgesic properties.

Option C: Correct. NSAID therapy does not decrease endometrial lining. Combination hormonal contraceptives improve dysmenorrhea by decreasing endometrial lining and inhibiting ovulation.

Option D: Incorrect. NSAID therapy does help reduce menstrual blood flow.

Which of the following treatment options for dysmenorrhea results in the most rapid symptom improvement?

A. NSAIDs

B. Levonorgestrel IUD

C. Standard cycle (28-day) combination oral contraceptive

D. Extended cycle (91-day) combination oral contraceptive

Answer: A

Option A: Correct. NSAID therapy is considered first-line for treatment of dysmenorrhea, and in many women, may show immediate relief of pain.

Option B: Incorrect. Progestin-only agents are appropriate treatment options for dysmenorrhea, but only after failure of NSAID therapy, and they work by reducing symptoms over time.

Option C: Incorrect. CHCs are effective options for management of dysmenorrhea, but often take 2–3 months of therapy to achieve full effects, and can take up to 6 months.

Option D: Incorrect. CHCs are effective options for management of dysmenorrhea, but often take 2–3 months of therapy to achieve full effects, and can take up ...

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