SOGC CLINICAL PRACTICE GUIDELINE Primary Dysmenorrhea Consensus Guideline

Methods: Members of this consensus group were selected based on individual expertise to represent a range of practical and academic experience both in terms of location in Canada and type of practice, as well as subspecialty expertise along with general gynaecology backgrounds. The consensus group reviewed all available evidence through the English and French medical literature and available data from a survey of Canadian women. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC. Results: This document provides a summary of up-to-date evidence regarding the diagnosis, investigations, and medical and surgical management of dysmenorrhea. The resulting recommendations may be adapted by individual health care workers when serving women who suffer from this condition. Conclusions: Dysmenorrhea is an extremely common and sometimes debilitating condition for women of reproductive age. A multidisciplinary approach involving a combination of lifestyle, medications, and allied health services should be used to limit the impact of this condition on activities of daily living. In some circumstances, surgery is required to offer the desired relief. Outcomes: This guideline discusses the various options in managing dysmenorrhea. Patient information materials may be derived from these guidelines in order to educate women in terms of their options and possible risks and benefits of various treatment strategies. Women who find an acceptable management strategy for this condition may benefit from an improved quality of life. Evidence: MEDLINE and Cochrane databases were searched for articles in English and French on subjects related to primary dysmenorrhea, menstrual pain and pelvic pain from January 1990 to December 2004 in order to prepare a Canadian consensus guideline on the management of primary dysmenorrhea. Values: The quality of evidence is rated using the criteria described in the Report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to this method. Sponsors: The development of this consensus guideline was supported by unrestricted educational grants from Pfizer Canada Inc., Janssen-Ortho, Wyeth, Organon Canada Ltd., and Berlex Canada Inc.