2018美国妇产科医师学会委员会意见:青少年痛经和子宫内膜异位症(No.760)的解读

Interpretation to the American College of Obstetricians and Gynecologists’Committee Opinion No.760:dysmenorrhea and endometriosis in the adolescent

痛经是青少年和年轻女性最常见的经期症状,大多数青少年为原发性痛经。病史提示为原发性痛经,可直接采用非甾体抗炎药或激素治疗,效果佳。若经治疗症状仍无改善,应检查可能存在的继发性原因和治疗的依从性。子宫内膜异位症是青少年继发性痛经的首要原因,是一种慢性疾病,在青少年中常被忽视导致延误诊治,不及时治疗会进一步恶化,治疗目标是缓解症状,预防疾病进展,保护生育能力。治疗需个体化,宣教和支持也非常重要。2018年美国妇产科医师学会(ACOG)发布了“青少年痛经和子宫内膜异位症委员会意见”,现对其进行解读。

Dysmenorrhea is the most common menstrual symptom among adolescent girls and young women.Most adolescents experiencing dysmenorrhea have primary dysmenorrhea.When the patient’s history suggests primary dysmenorrhea and will respond well to empiric treatment with nonsteroidal anti-inflammatory drugs(NSAIDs)or hormonal suppression,or both.When a patient does not experience clinical improvement for her dysmenorrhea with therapy,secondary causes and treatment adherence should be investigated.Endometriosis is the leading cause of secondary dysmenorrhea in asdolescents.Endometriosis in adolescents is considered a chronic disease with potential for progression if left untreated.Adolescents are particularly susceptible to delay in accessing diagnosis and treatment.The goals of therapy include symptom relief,suppression of disease progression,and protection of future fertility.Therapy must be individualized,and long-term patient and familial education and support are also important.This paper interpretated the American College of Obstetricians and Gynecologists'Committee Opinion:dysmenorrhea and endometriosis in the adolescent.