Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

Abstract

Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. It is characterized by painful cramps in the lower abdomen, which start shortly before or at the onset of menses and which could last for 3 days. In particular, PD negatively impacts the quality of life (QOL) of young females and is the main reason behind their absenteeism from school or work. It is suggested that increased intrauterine secretion of prostaglandins F2α and E2 are responsible for the pelvic pain associated with this disorder. Its associated symptoms are physical and/or psychological. Its physical symptoms include headache, lethargy, sleep disturbances, tender breasts, various body pains, disturbed appetite, nausea, vomiting, constipation or diarrhea, and increased urination, whereas its psychological symptoms include mood disturbances, such as anxiety, depression, and irritability. While its diagnosis is based on patients’ history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). Patients must be monitored to measure their response to treatment, assess their adherence, observe potential side effects, and perform further investigations, if needed.

Electroacupuncture Treatment for Primary Dysmenorrhea: A Review of Randomized Controlled Trials

“…This review evaluated the clinical effects of electroacupuncture treatment of PD by examining RCTs that used electroacupuncture only as a treatment intervention. PD refers to the presence of pain or cramps in the lower abdomen before or during menstruation without identifiable organic pathology [1,15]. The onset of PD usually occurs in adolescence, 6-24 months after menarche.…”

“…Primary dysmenorrhea (PD) is defined as cramping or painful cramps in the lower abdomen which originate from the uterus, occur without a specific cause, and appear just before or at the onset of menstruation. Cramping is one of the most common symptoms in both teenage and adult women [1][2][3]. Secondary dysmenorrhea refers to dysmenorrhea caused by a specific pelvic lesion.…”

“…Onset of dysmenorrhea occurs mainly in adolescence, within 6 to 24 months of menarche [1]. Globally, the prevalence of PD is between 45% and 95% of women of childbearing age, with 2% to 29% experiencing extreme pain [3].…”

Curative Effect of Heat-sensitive Moxibustion on Primary Dysmenorrhea: A Meta-Analysis

“…Possible concomitant symptoms include involved pain in the waist and sacrum, diarrhea, nausea and vomiting, fatigue, mood disorders, and syncope in severe cases. [ 4 ] The pathogenesis of PD is closely related to the increased secretion of prostaglandin F2 α (PGF2 α ) and prostaglandin E2(PGE2) in the late luteal phase, as well as the contraction of the smooth muscle and the blood vessels [ 5 ]. PD is a common gynecological disease.…”

“…The treatment of PD includes drug therapies, such as non-steroidal anti-inflammatory drugs (NSAIDs), hormones, as well as complementary and alternative therapies, such as moxibustion, acupuncture, and local hot compress [ 3 ]. Due to their high benefit, NSAIDs are recommended as the clinical first-line drugs of PD and have been widely used at present [ 5 ]. However, a systematic review [ 8 ] shows that NSAIDs used for PD may cause certain adverse reactions, including gastrointestinal symptoms (such as nausea and vomiting) and nervous system disorders (such as dizziness, headache, drowsiness, and exertion).…”