Dysmenorrhea - Patient Education (FC Version)

DYSMENORRHEA (Pain with menses):\n- Often related to endometriosis or adenomyosis (endometriosis in uterine muscle). Primarily surgical diagnosis, though history/exam may suggest it.\n- Endometriosis treatments: Medical therapies (hormonal suppression with contraceptives, Lupron, Danazol; supplements with off-label uses like N-acetylcysteine and Low Dose Naltrexone).\n- Dietary modifications to anti-inflammatory diets can significantly affect perceived symptoms but likely won't remove endometriosis. Recommend anti-inflammatory diet to decrease inflammation-associated pain.\n- Consider surgical evaluation and possibly treatment via laparoscopy, possibly with robotic assistance. If present, laser vaporization and/or excision recommended. Endometriosis releases toxins affecting reproductive function and increasing miscarriage risk. Can also cause scarring.\n- Surgical approaches: Electrosurgical cauterization/ablation most common but high recurrence (up to 60%) with significant scarring. Laser vaporization second best with ~20-25% recurrence. Excision best if possible with 5-10% recurrence. New lesions can form - rate not quotable.\n- OTC supplements for symptoms: 500mg magnesium daily, 500mg Red Raspberry Leaf tablets 3x/day on days of menses.\n- May be due to other causes: pelvic floor dysfunction, bladder problems (interstitial cystitis), bowel issues (IBD, IBS), nerve problems, others.\n- Occasionally pelvic floor physical therapy may be beneficial.