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Mittelschmerz is characterized by lower abdominal and pelvic pain that occurs roughly midway through a woman's menstrual cycle.The pain can appear suddenly and usually subsides within hours, although it may sometimes last two or three days.
Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life. [1] Treatment may include the use of a heating pad. [3] Medications that may help include NSAIDs such as ibuprofen, hormonal birth control and the IUD with progestogen. [1] [3] Taking vitamin B1 or magnesium may help. [2]
Ovarian suppression treatment with gonadotropin-releasing hormone agonist as an off-label use may reduce symptoms but have adverse side effects including decreased bone density. Other less commonly use medications such as alprazolam may reduce anxiety symptoms but has potential for dependence, tolerance, and abuse.
Other treatments target the underlying cause of the hematometra; for example, a hysteroscopy may be required to resect adhesions that have developed following a previous surgery. [1] If the cause of the hematometra is unclear, a biopsy of endometrial tissue can be taken to test for the presence of a neoplasm (cancer). [ 5 ]
Polymenorrhea is usually transient and self-limited, thereby not necessitating treatment. [4] If it persists, is disturbing, or if there is considerable blood loss due to the frequent periods, treatment may be indicated. [4] The mainstays of treatment are a progestogen during the luteal phase of the cycle or a combined oral contraceptive pill. [4]
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Combined oral contraceptives (COCs) can be used to treat menstrual cycle disorders including heavy menstrual bleeding, [9] and pelvic pain disorders such as endometriosis [10] and dysmenorrhea. [11] CHCs are also a first line treatment for polycystic ovary syndrome for menstrual abnormalities, acne, and hirsutism. [12]
The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20] The first line treatment option for those with HMB and no identified pathology, fibroids less than 3 cm in diameter, and/or suspected or confirmed adenomyosis is the levonorgestrel-releasing intrauterine system (LNG-IUS). [16]