Dysmenorrhea is one of the most common gynecological complaints in adolescence and, when severe, affects school attendance, physical activity and social life
Year: 2026
Type: book-chapter
Abstract: Dysmenorrhea is one of the most common gynecological complaints in adolescence and, when severe, affects school attendance, physical activity and social life. Most cases are primary, but pain that persists despite adequate treatment, worsens over time or extends beyond menstruation may point to a secondary cause, especially endometriosis. This narrative review discusses refractory dysmenorrhea as a warning sign for endometriosis in adolescents, focusing on clinical presentation, investigation, first-line management and psychosocial impact. Brazilian and international guidelines and official documents published between 2020 and 2026 were prioritized, complemented by earlier landmark studies. The evidence supports a structured clinical history, systematic assessment of functional impact, an age-appropriate physical examination and pelvic ultrasound when treatment fails or a secondary cause is suspected, bearing in mind that a normal image does not rule out the disease. Empirical treatment with NSAIDs and hormonal suppression can begin without surgical confirmation. Acknowledging symptoms, appropriate investigation and timely referral may help reduce diagnostic delay and functional impairment. Interpretation of the findings should consider the narrative design of the review and differences between the populations studied.
Source: Seven Editora eBooks
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7225197321