Primary Dysmenorrhea

Abstract

Primary dysmenorrhea is painful menstrual cramps without any evident pathology to account for them, and it occurs in up to 50% of menstruating females and causes significant disruption in quality of life and absenteeism. Current understanding implicates an excessive or imbalanced amount of prostanoids and possibly eicosanoids released from the endometrium during menstruation. The uterus is induced to contract frequently and dysrhythmically, with increased basal tone and increased active pressure. Uterine hypercontractility, reduced uterine blood flow, and increased peripheral nerve hypersensitivity induce pain. Diagnosis rests on a good history with negative pelvic evaluation findings. Evidence-based data support the efficacy of cyclooxygenase inhibitors, such as ibuprofen, naproxen sodium, and ketoprofen, and estrogen-progestin oral contraceptive pills (OCPs). Cyclooxygenase inhibitors reduce the amount of menstrual prostanoids released, with concomitant reduction in uterine hypercontractility, while OCPs inhibit endometrial development and decrease menstrual prostanoids. An algorithm is provided for a simple approach to the management of primary dysmenorrhea.

What women say about their dysmenorrhea: a qualitative thematic analysis

“…Yet consistent with previous studies [16, 22], we found that many participants experienced pain at multiple sites and reported a variety of gastrointestinal symptoms. Previous studies have reported that increased prostaglandins and pain sensitization among women with dysmenorrhea are likely to contribute to pain at multiple sites and gastrointestinal symptoms [3, 11, 27]. Assessment for dysmenorrhea should therefore include the evaluation of pain at different locations (e.g., abdomen, lower back, legs/upper thighs, vaginal area, and head) and query about gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea, and bloating).…”

“…Its prevalence among women of reproductive age ranges from 16 to 91% [2]. Dysmenorrhea is classified as primary if it occurs in the absence of underlying pathological findings or secondary if it is related to other conditions such as endometriosis, fibroids, or pelvic inflammatory diseases [1, 3, 4]. Without a pelvic examination, ultrasound, and/or diagnostic laparoscopy, primary and secondary dysmenorrhea cannot be fully differentiated [4], and the two types share similar symptomatic treatment approaches [5].…”

Epidemiology of Dysmenorrhea among University Students in Egypt

“…Various risk factors have been suggested to be associated with dysmenorrhea such as hormonal imbalance, failure to cope with stress, greater BMI, younger age of menarche, nutritional deficiencies, smoking or exposure to passive smoking, and lack of physical activity [5][6][7][8][9][10]. Although many international studies have investigated the epidemiology of dysmenorrhea among young women [11][12][13][14], only few national studies did [15][16][17].…”

Can Extracorporeal Magnetic Innervation Be a Treatment Modality for Primary Dysmenorrhea

“…nausea, headaches, depression, weight gain, thromboembolism) might limit the usage of these drugs [1,2,3,4,5]. …”

“…Dysmenorrhea is defined as cyclic, cramping pain in the lower abdomen/pelvis just before or during menstruation and effects 50% of women of fertile age, causing school or work abstinence [1]. Dysmenorrhea also has a negative impact on quality of life [2,3,4].…”