Primary Dysmenorrhea

Abstract

Primary dysmenorrhea is defined as pain during the menstrual cycle in the absence of an identifiable cause. It is one of the most common causes of pelvic pain in women. Dysmenorrhea can negatively affect a woman's quality of life and interfere with daily activities. The pathophysiology of primary dysmenorrhea is likely a result of the cyclooxygenase pathway producing increased prostanoids, particularly prostaglandins (PGs). The increased PGs cause uterine contractions that restrict blood flow and lead to the production of anaerobic metabolites that stimulate pain receptors. Women with a history typical for primary dysmenorrhea can initiate empiric treatment without additional testing. Shared decision making is key to effective management of dysmenorrhea to maximize patient compliance and satisfaction. After a discussion of their risks and benefits, extremely effective empiric therapies are nonsteroidal antiinflammatory drugs and contraceptive hormonal therapy. Other treatments for primary dysmenorrhea can be employed solely or in combination with other modalities, but the literature supporting their use is not as convincing. The physician should initiate an evaluation for secondary dysmenorrhea if the patient does not report improved symptomatology after being compliant with their medical regimen.

Moxibustion for Primary Dysmenorrhea: An Adjuvant Therapy for Pain Relief

“…However, the pathogenesis of PD is complex, and its pathological mechanism remains unclear. Moreover, the current treatment for PD can only alleviate the symptoms in some patients [ 2 ]. Currently, nonsteroidal anti-inflammatory drugs (NSAIDs) seem to be effective in treating PD, but their adverse reactions also pose some health risks [ 3 , 4 ].…”

Efficacy and safety of external therapy of TCM for primary dysmenorrhea

“…However, excessive contraction of the uterine muscle layer caused by the increase in menstrual prostaglandin levels has become increasingly stable. [6][7][8] Studies have shown that patients with PD have higher levels of prostaglandins released when their endometrium falls off than healthy women. [3] From the point of view of traditional Chinese medicine (TCM), the cause of PD is mainly dysfunction of the viscera, qi, and blood block and so on.…”

Computational systems pharmacology analysis of Tong-Jing-Yi formula in the treatment of dysmenorrhea

“…Dysmenorrhea refers to abdominal pain during menstruation that leads to lumbosacral pain, nausea, loss of appetite, headache, restlessness, insomnia, fatigue, diarrhea, and even syncope [1,2]. Dysmenorrhea can be classified into two main categories: primary dysmenorrhea (PD) and acquired dysmenorrhea (AD) [3]. PD is defined as pain during the menstrual cycle in the absence of an identifiable cause [3].…”

“…Dysmenorrhea can be classified into two main categories: primary dysmenorrhea (PD) and acquired dysmenorrhea (AD) [3]. PD is defined as pain during the menstrual cycle in the absence of an identifiable cause [3]. AD refers to dysmenorrhea caused by pelvic organic diseases such as endometriosis, adenomyosis, chronic pelvic inflammation, uterine malformation and so on [4].…”

“…Both PG synthase inhibitors such as nonsteroidal anti-inflammatory drugs [6] and oral contraceptives are prescribed for dysmenorrhea. PG synthetase inhibitors suppress PG production by inhibiting the activity of PG synthetase, which prevents excessive uterine contraction and spasm and consequently alleviates or eliminates dysmenorrhea [3]. Oral contraceptives reduce the PG content in men-strual blood by inhibiting ovulation [7].…”