Women Health – Week 2 Discussion 2nd REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates. 
Discussion
When conduction an interview for a patient with dysmenorrhea, it is essential to ask personal questions regarding sexual life, like how many partners the patient has. In addition, we should ask about the menstrual cycles, what medications the patient takes for abdominal cramping, how is the pain, how is the bleeding if is any, what birth control the patient is taking, history of chronic or acute diseases, how many pregnancies, and how the pregnancies were.
Patients with dysmenorrhea can presents with difficult or painful menstruation, pain during intercourse, bleeding between cycles or after intercourse, vomiting, and diarrhea. In addition to suprapubic tenderness and an increase in the uterus size.
After conducting the interview, should do a physical exam. We should also order a Human chorionic gonadotropin, a complete blood count, a pelvic ultrasound, and a thyroid-stimulating hormone. Should do a pregnancy test because some pregnancies can cause heavy bleeding, a complete blood count because bleeding can cause iron deficit anemia, the ultrasound can detect intracavitary abnormalities, and a thyroid-stimulating test because thyroid problem is sometimes the cause fatigue and bowel symptoms.
The primary diagnosis is dysmenorrhea because of the painful periods, heavy bleeding, and tenderness over the suprapubic area. The secondary diagnoses are adenomyosis, after all, the patient complains of menorrhagia, Chronic pelvic inflammatory disease because the patient presents with lower abdominal pain, and Fibroids because of the pain and changes in menstruation.
The pain during the menstrual cycle can be treated with Ibuprofen which is the gold standard anti-inflammatory treatment for dysmenorrhea; we can also use combined oral contraceptive pills to help regulate the menstrual cycle. Other treatments can include acupuncture, acupressure, and superficial needling. At this point, no referral is needed, but the patient should have follow-up visits, and she should be encouraged to report any change in her medical condition. 
References
Family medicine 32: 33-year-old female with painful periods. (n.d.). South University College of Nursing and Public Health Graduate Online Nursing Program. https://southu-nur.meduapp.com/document_set_document_relations/30252
Hawkins, J. W., Diane M. Roberto-Nichols, B., & Stanley-Haney-C, J. L. (2015). Guidelines for nurse practitioners in Gynecologic settings (11th ed.). Springer Publishing Company