Menstruation-related disorders treatment

Measure the treatment success for the various menstruation-related disorders by the degree to which the care plan (1) relieves or reverses symptoms of the disorder, (2) prevents or reverses the complications of the disorder (e.g., osteoporosis, anemia, and infertility), and (3) minimizes side effects. The return of a regular menstrual cycle with minimal premenstrual symptoms or symptoms of dysmenorrhea should occur. Depending on the desire for conception and subsequent therapy, this cycle may be ovulatory or anovulatory. 

In general, five different treatment strategies are used for menstruation-related disorders (1) lifestyle changes to minimize pre-cipitants, (2) physical and behavioral symptom relief, (3) modification of neurotransmitter/hormonal imbalances, (4) suppression of ovulation, and (5) removal of ovaries. 

A great number of lifestyle changes and nonpharmacologic treatments are promoted for menstruation-related disorders without evidence-based studies. " Examples of lifestyle modifications and nondrug remedies recommended for menstruation-related disorders are listed in Table 78-3. 

There are no published consensus guidelines for the treatment of menstruation-related disorders. Information about pharmacologic... 

TABLE 78—3. Nonpharmacologic Treatments for Menstruation-Related Disorders... 

Patients who are undergoing therapy for menstruation-related disorders should have a monthly examination by a clinician to assess efficacy and adverse effects and adjust dosing, if needed. If first-line treatment approaches are not effective after several months, then alternative or combination therapies should be considered. Perimenopausal women should be monitored every 1 to 2 months to determine the effectiveness of treatment. Once a patient is stable and responding to the treatmentplan, monitoring may be extended to every 3 to 6 months. Peri- and postmenopausal women should be monitored regularly because of the increased risk of osteoporosis, cardiovascular disease, and dementia. Throughout therapy, patients should be... 

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