PRIMARY DYSMENORRHEA

TAN MEI LEE 260110142014

EU JOHNNY 260110142016
JACKIE KANG SING LUNG 260110142017
MAISARAH GHOZALI 260110142019
NUR FARAH FARHANAH 260110142020
BIBI YASIMAH 260110142021
FARKANAH RAHMI 260110142023

INTRODUCTION
Dysmenorrhea
painful cramps that occur with menstruation

Primary dysmenorrhea
pain without organic pathology

initial onset usually occurs within six to 12

months after menarche
Pain duration is commonly eight to 72
hours

secondary dysmenorrhea
pelvic pain associated with an
identifiable pathologic condition,
such as endometriosis

Initial onset occur at any time after

menarche

EPIDEMIOLOGY
THE PREVALENCE OF DYSMENORRHEA IS HIGHEST IN ADOLESCENT WOMEN,
WITH ESTIMATES RANGING FROM 20 TO 90 PERCENT
A RECENT PROSPECTIVE STUDY OF COLLEGE STUDENTS FOR ONE YEAR,
FOUND THAT 72 PERCENT OF MONITORED PERIODS WERE PAINFUL, MOST
COMMONLY DURING THE FIRST DAY OF MENSES. SIXTY PERCENT OF THE
WOMEN STUDIED REPORTED AT LEAST ONE EPISODE OF SEVERE PAIN.
o IN SEVERAL LONGITUDINAL STUDIES OF YOUNG WOMEN, RATES OF
ABSENTEEISM RANGED FROM 34 TO 50 PERCENT.

ETIOLOGY
MAIN CAUSE: INCREACE PRODUCTION OF PROSTAGLANDIN (PGF2)

SIGN AND SYMPTOM

MAIN SYMPTOM: PAIN (LOWER ABDOMEN)
OTHER SYMPTOM:
NAUSEA
VOMITING
LOOSE BOWEL MOVEMENTS/DIARRHEA
CONSTIPATION
BLOATING IN THE BELLY AREA
HEADACHES

2.FAKTOR YANG BERPERAN SEBAGAI

PENYEBAB DISMENORE
A.FAKTOR KEJIWAAN.
PADA REMAJA PUTERI YANG SECARA EMOSIONAL TIDAK STABIL, APALAGI JIKA MEREKA TIDAK MENDAPAT
PENERANGAN YANG BAIK TENTANG PROSES HAID, MUDAH TIMBUL DISMENORE.
B.FAKTOR KONSTITUSI.
FAKTOR-FAKTOR SEPERTI ANEMIA, PENYAKIT MENAHUN, DAN SEBAGAINYA DAPAT MEMPENGARUHI TIMBULNYA
DISMENORE.
C.FAKTOROBSTRUKSI KANALIS SERVIKALIS.
PADA WANITA DENGAN UTERUS DALAMHIPERANTEFLEKSIMUNGKIN DAPAT TERJADISTENOSIS KANALIS
SERVIKALIS
D.FAKTOR ENDOKRIN.
PADA UMUMNYA ADA ANGGAPAN BAHWA KEJANG YANG TERJADI PADA DISMENORE DISEBABKAN OLEH
KONTRAKSI UTERUS YANG BERLEBIHAN.
E.FAKTOR ALERGI.
TEORI INI DIKEMUKAKAN SETELAH MEMPERHATIKAN ADANYA ASOSIASI ANTARA DISMENORE DENGANURTIKARIA,
MIGRAINEATAUASMA BRONKHIALI.SMITH MENDUGA BAHWA SEBAB DARI ALERGI IALAH TOKSIN HAID/
DALAM PENELITIAN KE DEPAN, TERNYATA ETIOLOGI DISMENORE PRIMER YANG PALING BERPERAN ADALAH
PENINGKATAN KADAR PROSTAGLANDIN(WIKNJOSASTRO, 2008).

3A.APAKAH ASAM MEFENAMAT?

ASAM MEFENAMAT MERUPAKAN SALAH SATU JENIS OBAT ANTI INFLAMASI
NON-STEROID. OBAT INI BERFUNGSI MEREDAKAN RASA SAKIT TINGKAT
RINGAN HINGGA MENENGAH, SERTA MENGURANGI INFLAMASI ATAU
PERADANGAN.

 CONTOH RASA SAKIT AKIBAT INFLAMASI YANG UMUMNYA DAPAT DIATASI

DENGAN ASAM MEFENAMAT ADALAH ARTRITIS, NYERI MENSTRUASI, SERTA
NYERI SETELAH OPERASI. SELAIN MENGATASI NYERI MENSTRUASI, OBAT INI
JUGA DAPAT DIGUNAKAN UNTUK MENGURANGI VOLUME PENDARAHAN YANG
PARAH SAATMENSTRUASI.
ASAM MEFENAMAT BERFUNGSI MENGHAMBAT ENZIM YANG MEMPRODUKSI
PROSTAGLANDIN. PROSTAGLANDIN ADALAH SENYAWA YANG DILEPAS TUBUH
DAN MENYEBABKAN RASA SAKIT SERTA INFLAMASI. DENGAN MENGHALANGI
PRODUKSI PROSTAGLANDIN, ASAM MEFENAMAT AKAN MENGURANGI RASA
SAKIT DAN INFLAMASI.

MEKANISM AKSI ASAM MEFENAMAT

TERHADAP PRIMARY DYSMENORRHEA
HAS ANALGESIC, ANTI-INFLAMMATORY, AND ANTIPYRETIC PROPERTIES.
IS A POTENT INHIBITOR OF PROSTAGLADIN SYSTHESIS IN VITRO. MEFENAMIC
ACID CONCENTRATIONS REACHED DURING THERAPY HAVE PRODUCED IN
VIVO EFFECTS.
PROSTAGLADINS SENSITIZE AFFERENT NERVES AND POTENTIATE THE ACTION
OF BRADYKININ IN INDUCING PAIN. PROSTAGLADINS ARE MEDIATORS OF
INFLAMMATION. BECAUSE MEFENAMIC ACID IS AN INHIBITOR OF
PROSTAGLADIN SYNTHESIS, ITS MODE OF ACTION TO DECREASE OF
PROSTAGLADIN IN PERIPHERAL TISSUES.

TREATMENT FOR PRIMARY

DYSMENORRHEA

SIDE EFFECTS
MORE COMMON

NAUSEA

RASHES

SWELLING

CHEST PAIN

CONSTIPATI
ON

LESS COMMON

DIZZINESS

LOST OF
APPETITE

STOMACH
UPSET

RARE

DIARRHEA

FAST &
SLOW
BREATHING

DROWSINES
S

HIGH FEVER

NON-DRUG THERAPHY

TUMERIC

THE ANTIINFLAMMATORY AND ANTIOXIDANT ACTIVITY

PHENOLIC FRACTION, CURCUMINOIDS, WHICH ACT AS FREE
RADICAL SCAVENGERS AS WELL AS INHIBITORS OF
LEUKOTRIENES AND PROSTAGLANDIN SYNTHESIS

VITAMIN E

INHIBITS THE RELEASE OF ARACHIDONIC ACID AND ITS

CONVERSION TO PROSTAGLANDIN
TAKEN 2 DAYS BEFORE AND 3 DAYS AFTER ONSET OF
MENSES (500 MG/DAY)

MAGNESIUM, CALCIUM

MAGNESIUM IS THOUGHT TO RELIEVE CRAMPING BY

HELPING RELAX MUSCLES AND INCREASING THE
ABSORPTION OF CALCIUM.
CALCIUM MAY ALSO HELP REDUCE MENSTRUAL PAIN
BECAUSE IT HELPS MAINTAIN MUSCLE TONE.

TRANSDERMAL NITROGLYCERINE

HAS A RELAXING EFFECT ON MYOMETRIUM.

(A NITRIC OXIDE DONOR) EFFECTIVE IN INHIBITING UTERINE

CONTRACTILITY.
REDUCES THE PAIN IN PRIMARY DYSMENORRHEA

TRANSCUTANEOUS ELECTRICAL NERVE

STIMULATION (TENS)
ELECTRODES ARE PLACED ON THE SKIN
AND ELECTRIC CURRENT APPLIED AT
DIFFERENT PULSE RATES AND INTENSITIES
TO STIMULATE THESE AREAS IN EFFORTS
TO PROVIDE PAIN RELIEF.

HIGH FREQUENCY TENS-CONSISTS OF

PULSES DELIVERED AT 50-120 HZ AT A
LOW INTENSITY
LOW-FREQUENCY TENS -CONSISTS OF
PULSES DELIVERED AT 1-4 HZ AT HIGH
INTENSITY AND WITH LONG PULSE WIDTH

PRESACRAL NEURECTOMY

FOR INDIVIDUALS WHO DO NOT

RESPOND TO MEDICATION ,WHO
CONTINUE TO SUFFER FROM SEVERE
PRIMARY DYSMENORRHEA

PRESACRAL NEURECTOMY INTERRUPTS

THE SYMPATHETIC NERVES OF THE
UTERUS NEAR THE SUPERIOR
HYPOGASTRIC PLEXUS.

LAPAROSCOPIC UTERINE NERVE ABLATION

(LUNA)
DESTROYS UTERINE NERVE
FIBERS AS THEY LEAVE THE
UTERUS VIA THE UTEROSACRAL LIGAMENTS

SELF THERAPHY TECHNIQUES

COUNSELING

MEDICAL WARNING

THESE MEDICINES MAY INTERACT AND CAUSE VERY HARMFUL

EFFECTS, SO TAKING BOTH IS PROBABLY OVER-KILL.

HOW INTERACTION OCCUR

INCREASE CHANCES OF SIDE EFFECTS SUCH AS STOMACH
UPSET AND OTHER GASTROINTESTINAL COMPLAINTS.
INCREASE EFFECT OF ANTICOAGULANT.

WHAT MIGHT HAPPEN

TAKING THESE MEDICINES TOGETHER MAY INCREASE YOUR
RISK FOR BLEEDING OR BRUISING.

FORMULATION OF MEFENAMIC ACID

DAFTAR PUSTAKA
JAMIESON DJ, STEEGE JF. THE PREVALENCE OF DYSMENORRHEA, DYSPAREUNIA, PELVIC PAIN, AND
IRRITABLE BOWEL SYNDROME IN PRIMARY CARE PRACTICES. OBSTET GYNECOL. 1996;87:558.
HARLOW SD, PARK M. A LONGITUDINAL STUDY OF RISK FACTORS FOR THE OCCURRENCE, DURATION
AND SEVERITY OF MENSTRUAL CRAMPS IN A COHORT OF COLLEGE WOMEN. BR J OBSTET GYNAECOL.
1996;103:113442 [PUBLISHED ERRATUM IN BR J OBSTET GYNAECOL. 1997;104:386].
ANDERSCH B, MILSOM I. AN EPIDEMIOLOGIC STUDY OF YOUNG WOMEN WITH DYSMENORRHEA. AM J
OBSTET GYNECOL. 1982;144:65560.
SUNDELL G, MILSON I, ANDERSCH B. FACTORS INFLUENCING THE PREVALENCE AND SEVERITY OF
DYSMENORRHEA IN YOUNG WOMEN. BR J OBSTET GYNAECOL. 1990;97:58894.
DAWOOD MY. IBUPROFEN AND DYSMENORRHEA. AM J MED. 1984;77:8794.
PARAZZINI F, TOZZI L, MEZZOPANE R, LUCHINI L, MARCHINI M, FEDELE L. CIGARETTE SMOKING,
ALCOHOL CONSUMPTION, AND RISK OF PRIMARY DYSMENORRHEA. EPIDEMIOLOGY. 1994;5:46972.
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