Dysmenorrhoea.

BACKGROUND

Menstruation has dual significance for women. From one perspective it defines the start and end of reproductive potential, an affirmation of womanhood. On the other, just as the ancients observed taboos of menstruation, many women (and men) today are still influenced by outdated negative messages.

OBJECTIVE

This article discusses an approach to assessment and management of dysmenorrhoea that considers the cultural, social and personal significance of symptoms and management choices.

DISCUSSION

Cultural influences, such as a woman's status within society, her life stage, religion, education and employment, determine whether a woman seeks medical help for menstrual problems, and the personal significance of dysmenorrhoea. Assessment involves consideration of pain, associated symptoms, effect on lifestyle and activities of daily living, and a psychosocial and cultural assessment. Management involves specific treatment of underlying pathology, psychosocial support and individualising treatment according to impact of the pain, associated symptoms, reproductive stage, cost, and the woman's personal values and attitudes.