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Membranous dysmenorrhea: a complication of treatment for endometriosis.
Obstet Gynecol 2010; 116 Suppl 2:488-90OG

Abstract

BACKGROUND

Progesterones are frequently used to treat endometriosis. Exaggerated response of the endometrium to high levels of progesterone can result in a decidualization reaction. Decidualization may cause an exacerbation of symptoms of dysmenorrhea associated with endometriosis.

CASE

A 16-year-old girl with uterine didelphys and obstructed hemivagina presented with irregular bleeding and severe abdominal cramping after resection of the vaginal septum. Persistent endometriosis treated with norethindrone acetate resulted in severe colicky abdominal pain and expulsion of a decidual cast.

CONCLUSION

Membranous dysmenorrhea can occur in response to excess progesterones. An understanding of the physiologic response of the endometrium to treatment will guide us to a high clinical suspicion of this rare entity when symptoms worsen in response to progesteronal treatment for endometriosis.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Division of Pediatric and Adolescent Gynecology, Long Island Jewish Medical Center/Steven and Alexandra Cohen Children's Medical Center of New York, USA. happelba@lij.edu

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20664428

Citation

Appelbaum, Heather. "Membranous Dysmenorrhea: a Complication of Treatment for Endometriosis." Obstetrics and Gynecology, vol. 116 Suppl 2, 2010, pp. 488-90.
Appelbaum H. Membranous dysmenorrhea: a complication of treatment for endometriosis. Obstet Gynecol. 2010;116 Suppl 2:488-90.
Appelbaum, H. (2010). Membranous dysmenorrhea: a complication of treatment for endometriosis. Obstetrics and Gynecology, 116 Suppl 2, pp. 488-90. doi:10.1097/AOG.0b013e3181d4473c.
Appelbaum H. Membranous Dysmenorrhea: a Complication of Treatment for Endometriosis. Obstet Gynecol. 2010;116 Suppl 2:488-90. PubMed PMID: 20664428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Membranous dysmenorrhea: a complication of treatment for endometriosis. A1 - Appelbaum,Heather, PY - 2010/7/29/entrez PY - 2010/7/29/pubmed PY - 2010/8/25/medline SP - 488 EP - 90 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 116 Suppl 2 N2 - BACKGROUND: Progesterones are frequently used to treat endometriosis. Exaggerated response of the endometrium to high levels of progesterone can result in a decidualization reaction. Decidualization may cause an exacerbation of symptoms of dysmenorrhea associated with endometriosis. CASE: A 16-year-old girl with uterine didelphys and obstructed hemivagina presented with irregular bleeding and severe abdominal cramping after resection of the vaginal septum. Persistent endometriosis treated with norethindrone acetate resulted in severe colicky abdominal pain and expulsion of a decidual cast. CONCLUSION: Membranous dysmenorrhea can occur in response to excess progesterones. An understanding of the physiologic response of the endometrium to treatment will guide us to a high clinical suspicion of this rare entity when symptoms worsen in response to progesteronal treatment for endometriosis. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/20664428/Membranous_dysmenorrhea:_a_complication_of_treatment_for_endometriosis_ L2 - http://Insights.ovid.com/pubmed?pmid=20664428 DB - PRIME DP - Unbound Medicine ER -