La dysménorrhée: Un problème pour le pédiatre ?

Dysmenorrhea is common in adolescent years, especially after the onset of ovulatory cycles, usually 2to 3years after menarche. Pain and symptoms are responsible for school absenteeism and interruption of sports and social activities. Objectives: This study aims to measure the prevalence of severe dysmenorrhea and its consequences on adolescent girls in Switzerland. Treatment of dysmenorrhea is discussed and recommendations for clinical practice are given. Study design: Cross sectional survey (SMASH 02) on a nationally representative sample of adolescents (n=7548; 3340females), aged 16to 20years who attended post-mandatory education. A self-administered questionnaire was used to assess the severity of dysmenorrhea and its consequences on daily life pursuit of medical help and medications used. Results: Among 3340girls, 86.6% suffered from dysmenorrhea-related symptoms: 12.4% described having severe dysmenorrhea and 74.2% moderate dysmenorrhea. Girls with severe dysmenorrhea described heavier consequences on daily activities compared with girls without dysmenorrhea: 47.8% of girls with severe dysmenorrhea reported staying at home and 66.5% declared reducing their sportive activities. Yet, fewer than half have consulted a physician for this complaint and even fewer were treated properly. Recommendation: The pediatrician has a pivotal role in screening young patients for dysmenorrhea, as well as, educating and effectively treating adolescent girls with menstruation-associated symptoms. Non-steroidal anti-inflammatory drugs are considered the first-line of treatment for dysmenorrhea, and adolescents with symptoms that do not respond to this treatment for 3menstrual periods should be offered combined oestroprogestative contraception and must be followed up, as non-responders may have an underlying organic pathology. Conclusion: Dysmenorrhea is a frequent health problem in adolescent years and adolescent care providers should be able to care for these patients in an efficient way.