Menstruation Disorders Kuma

Front 1

Signs and Symptoms
Primary dysmenorrhea

Back 1

Pain is cyclic and directly related to the onset of menstruation. Dull aching pain with spasmodic cramping in the lower midabdominal or suprapubic area. Age typically 12-13 years old. Pain lasting 2-3 days. Other symptoms include: N/V, fatigue, dizziness, irritability, diarrhea, and HA

Front 2

Signs and Symptoms
Premenstrual Syndrome(PMS)

Back 2

Fatigue, irritability, labile mood with altering sadness and anger, depression, oversensitivity, crying spells, social withdraw, forgetfulness, difficulty concentrating, abdominal bloating, breast tenderness, acne, appetite changes and food cravings, swelling of the extremities, HA, GI upset

Front 3

Signs and Symptoms
Toxic Shock Syndrome (TSS)

Back 3

Occurs within 2 days of onset of menses, during menses or within 2 days after menses. Prodromal symptoms(malaise, myalgias, and chills) occur 2-3 days prior to TSS. GI symptoms (vomiting, diarrhea, and abdominal pain) typically occur early in the illness and affect almost all patients. TSS evolves rapidly. Full blown TSS includes high fever, myalgias, vomiting, and diarrhea, erythroderma, decreased urine output, severe hypotension, and shock. Neurological manifestations (HA, confusion, agitation, lethargy, and seizures) Acute renal failure, cardiac involvement and adult respiratory distress syndorme are also common

Front 4

NSAIDs
dosing

Back 4

1.Ibuprofen 200-400mg q4-6h (max 1200mg/day)

2.Ketoprofen 12.5-25mg q4-6h (DNE 25mg in 6 hrs, 75mg/day)

3.ASA 650-1000mg q4-6h (max 4000mg/day)

4.Naproxen 22-440mg initially, then 22mg q8-12h (max 660mg/day)

Front 5

Analgesics--> APAP
dosing

Back 5

APAP 650-1000mgq4-6h (max 4000mg/day)

Front 6

Diruretics
dosing

Back 6

1.Ammonium Chloride 3g/day in divided doses, max of 6 days

2.Caffeine 100-200mg q3-4h (patients can build tolerance)

3.Pamabrom 50mg QID

Front 7

Supplements
dosing

Back 7

1.Pyridoxine (Vit B6)
a.No effective dose proven, max of 100mg/day due to risk of side effects.
b. helps with mastalgia, irritability, fatigue, bloating

2.Vitamin E
a.400IU daily is sometimes recommended to alleviate breast tenderness but evidence is lacking.

3.Calcium
a.600mg BID has been convincingly shown to reduce symptoms dramatically. It must be taken regularly and long-term. Effects were most noticeable in the second and third months of treatment. In study 50% of women had greater than 50% reduction of sxm, 29% had greater than 75% reduction.
b. helps with emotional, physical symptoms(cravings, breast tenderness)
4.Magnesium
a.360mg daily during luteal phase. Too much=diarrhea