Physician's knowledge and treatment of primary dysmenorrhea.

Recent advances in knowledge have increased understanding of the etiology of primary dysmenorrhea and provided new approaches to the treatment of this disorder. Primary care physicians in Missouri have been surveyed to determine the extent to which new knowledge about primary dysmenorrhea has been utilized in patient care. The majority of physicians who responded to a mailed questionnaire were aware of the role of prostaglandins in the pathogenesis of dysmenorrhea and used prostaglandin inhibitors in management. Congenital cervical stenosis, neurosis, and physical inactivity were also frequently cited as causal factors of this disorder. Older physicians and osteopathic physicians were less likely to prescribe prostaglandin synthetase inhibitors for this condition. The reported prevalence of dysmenorrhea in the respondent's practice was lower than that estimated in the literature. The findings suggest that the condition is underdiagnosed and that effective pharmacotherapy may be underutilized.