ACTIVITY NUMBER: RES005
ACTIVITY TITLE: Dysmenorrhea
ACCREDITATION STATEMENT
The American Society for Reproductive Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Release Date: October 1, 2012
Reviewed and Updated in 2015
Reviewed and Updated in 2018
Expiration Date: October 1, 2021
Under Review June 2022
Estimated Time to Complete Activity: 1.0 hour
NEEDS ASSESSMENT and IDENTIFICATION OF PRACTICE GAP
Dysmenorrhea is often considered the most common gynecological complaint. However, this condition is underdiagnosed and undertreated as few women with dysmenorrhea believe treatment will help and thus do not seek it. Historically, dysmenorrhea was attributed to a variety of emotional or psychological problems, but the prostaglandin secretion implicated in both primary and secondary dysmenorrhea now provides of evidence of a physiologic mechanism. Simple analgesics and non-steroidal anti-inflammatory agents are effective in most women, but the diagnosis and management of secondary dysmenorrhea is complicated by the overlap with other related disorders such as endometriosis. In addition, there is no clear relationship between the prognosis of secondary dysmenorrhea and the severity of underlying disease, which can complicate diagnosis. In surveys of practicing obstetrician-gynecologists, dysmenorrhea was one of the most common benign gynecology diagnoses for office practice and was seen as among the most important for resident education. The diagnosis and treatment of bleeding disorders has been identified as a physician practice gap for reproductive care physicians based on recent competence assessments by the American Society for Reproductive Medicine.
This educational activity is designed to address the Unit 5 Reproductive Endocrinology educational objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG) on this topic.
EDUCATIONAL OBJECTIVES
At the conclusion of the educational activity, participants should be able to:
1. Classify dysmenorrhea.
2. List the principal causes of primary and secondary dysmenorrhea.
3. Elicit a pertinent history to evaluate dysmenorrhea.
4. List the essential components of a focused physical examination to evaluate dysmenorrhea.
5. Interpret selected tests to evaluate dysmenorrhea.
6. Identify medical and surgical treatments for dysmenorrhea.
7. Describe long-term follow-up and prognosis for a patient with dysmenorrhea.
TARGET AUDIENCE
This activity is designed to meet the educational needs of resident physicians in obstetrics and gynecology and other related specialties.
ACGME COMPETENCIES
Medical Knowledge
Patient Care
Interpersonal and Communication Skills
SUCCESSFUL COMPLETION REQUIREMENTS
Successful completion of this educational activity requires the learner to:
· View a course overview page, containing all CME and disclosure information, including acknowledgement of commercial support and disclosure of unlabeled use, prior to the start of each module.
· Complete a 10-question pre-exam prior to the module. Learners should note any pre-exam questions answered incorrectly for clarification during module study.
· Be given the option of downloading a printed syllabus containing the presentation and narrative.
· Participate in the interactive activity: Audio narration is synchronized with PowerPoint presentation that can be advanced, stopped or reversed as desired.
· Complete a 10-question post-exam, with feedback of correct/incorrect answers, scoring a minimum of 70% in two attempts.
· Complete the evaluation survey.
· Print certificate of completion.
DISCLOSURES FOR PLANNERS
Nancy A. Bowers, BSN, RN, MPH – Nothing to Disclose
Andrew R. La Barbera, PhD, HCLD – Nothing to Disclose
Richard H. Reindollar, MD – Nothing to Disclose
DISCLOSURES FOR FACULTY
Ruben J. Alvero, MD – Nothing to Disclose
Paula Amato, MD – Nothing to Disclose
Alicia Y. Armstrong, MD – Nothing to Disclose
Valerie Baker, MD – Institutional Support from IBSA
Bruce R. Carr, MD – Research support from Wyeth, Neurocrine, Boehringer Ingelheim; Consultant for Novo Nordisk
Marcelle I. Cedars, MD – Nothing to Disclose
Bradley S. Hurst, MD – Nothing to Disclose
Helen Kim, MD – Nothing to Disclose
Erica Johnstone, MD – Nothing to Disclose
Emily Jungheim, MD – Consultant for Abbvie, Genentech, Spectrum, Celgene
Lawrence C. Layman, MD – Nothing to Disclose
Richard Legro, MD – Consultant: Euroscreen; Astra Zeneca; Takeda; Clarus Therapeutics; Grant/Research: Astra Zeneca, Ferring
Meredith Loveless, MD – Nothing to Disclose
Elizabeth McGee, MD – Nothing to Disclose
Patricia M. McShane, MD – Consultant, World Egg Bank
Shona C. Murray, MD - Consultant, World Egg Bank
Steven T. Nakajima, MD –Consultant, research support, speaker’s bureau for Warner Chilcott; Stockholder for IntegraMed
Genevieve Neal-Perry, MD, PhD – Nothing to Disclose
Linda R. Nelson, MD, PhD – Nothing to Disclose
Lubna Pal, MBBS, MS – Research grant from Ferring
Staci E. Pollack, MD – Nothing to Disclose
Robert W. Rebar, MD – Nothing to Disclose
Nanette Santoro, MD – Consultant for QuatRx
James H. Segars, MD – Nothing to Disclose
Cynthia Sites, MD – Nothing to Disclose
Anne Steiner, MD – Nothing to Disclose
Mary D. Stephenson, MD, MSc – Consultant for NoraTherapeutics
Michael Thomas, MD – Consultant: Teva
Kim L. Thornton, MD – Consultant for Parexel
Kimberly Thornton, MD – Nothing to Disclose
Lynn Westphal, MD – Nothing to Disclose
Ellen Wilson, MD – Nothing to Disclose
Bo Yu, MD – Nothing to Disclose
It is the policy of the ASRM to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty/authors participating in this activity were required to disclose any relationships they may have with commercial entities whose products or services are used to treat patients so that participants may evaluate the objectivity of the presentations. The content and views presented in this activity are those of the faculty/authors and do not necessarily reflect those of the ASRM or CREOG. Any discussion of off-label, experimental, or investigational use of drugs or devices will also be disclosed. The disclosure statements were reviewed by the Subcommittee for Standards of Commercial Support of the CME Committee of ASRM and any perceived conflicts of interest were resolved in accordance with the policies of the ACCME.
STATEMENT OF SUPPORT
No commercial support has been provided for this activity.