Narring F, Yaron M, Ambresin A-E
Unité santé jeunes, département de l'enfant et de l'adolescent, université de Genève, hôpitaux universitaires de Genève, 87, boulevard de la Cluse, 1211 Genève 14, Suisse.
Arch Pediatr. 2012 Feb;19(2):125-30. doi: 10.1016/j.arcped.2011.11.009. Epub 2011 Dec 22.
Dysmenorrhea is common in adolescent years, especially after the onset of ovulatory cycles, usually 2 to 3 years after menarche. Pain and symptoms are responsible for school absenteeism and interruption of sports and social activities.
This study aims to measure the prevalence of severe dysmenorrhea and its consequences on adolescent girls in Switzerland. Treatment of dysmenorrhea is discussed and recommendations for clinical practice are given.
Cross sectional survey (SMASH 02) on a nationally representative sample of adolescents (n=7548; 3340 females), aged 16 to 20 years who attended post-mandatory education. A self-administered questionnaire was used to assess the severity of dysmenorrhea and its consequences on daily life pursuit of medical help and medications used.
Among 3340 girls, 86.6% suffered from dysmenorrhea-related symptoms: 12.4% described having severe dysmenorrhea and 74.2% moderate dysmenorrhea. Girls with severe dysmenorrhea described heavier consequences on daily activities compared with girls without dysmenorrhea: 47.8% of girls with severe dysmenorrhea reported staying at home and 66.5% declared reducing their sportive activities. Yet, fewer than half have consulted a physician for this complaint and even fewer were treated properly.
The pediatrician has a pivotal role in screening young patients for dysmenorrhea, as well as, educating and effectively treating adolescent girls with menstruation-associated symptoms. Non-steroidal anti-inflammatory drugs are considered the first-line of treatment for dysmenorrhea, and adolescents with symptoms that do not respond to this treatment for 3 menstrual periods should be offered combined oestroprogestative contraception and must be followed up, as non-responders may have an underlying organic pathology.
Dysmenorrhea is a frequent health problem in adolescent years and adolescent care providers should be able to care for these patients in an efficient way.
痛经在青少年时期很常见，尤其是在排卵周期开始后，通常在月经初潮后2至3年。疼痛和症状会导致缺课以及体育和社交活动中断。
本研究旨在衡量瑞士青少年女性中严重痛经的患病率及其后果。讨论了痛经的治疗方法并给出了临床实践建议。
对16至20岁接受义务教育后的青少年（n = 7548；3340名女性）进行全国代表性样本的横断面调查（SMASH 02）。使用一份自填式问卷来评估痛经的严重程度及其对日常生活、寻求医疗帮助和所用药物的影响。
在3340名女孩中，86.6%患有与痛经相关的症状：12.4%称有严重痛经，74.2%称有中度痛经。与无痛经的女孩相比，有严重痛经的女孩对日常活动的影响更大：47.8%有严重痛经的女孩报告呆在家里，66.5%称减少了体育活动。然而，因这种情况咨询医生的不到一半，得到恰当治疗的更少。
儿科医生在筛查年轻患者的痛经情况以及教育和有效治疗有月经相关症状的青少年女孩方面起着关键作用。非甾体抗炎药被认为是痛经的一线治疗药物，对这种治疗3个月经周期无反应的青少年应给予雌孕激素联合避孕治疗，并且必须进行随访，因为无反应者可能有潜在的器质性病变。
痛经是青少年时期常见的健康问题，青少年护理人员应能够有效地照顾这些患者。
