Dysmenorrhea is defined as difficult menstrual flow or painful menstruation. The term dysmenorrhea is derived from the Greek words dys, meaning difficult/painful/abnormal,meno, meaning month, and rrhea, meaning flow.
It is one of the most common gynecologic complaints in young women who present to clinicians.
Classification
Dysmenorrhea is classified as
Primary (spasmodic): Primary dysmenorrhea is defined as menstrual pain not associated with macroscopic pelvic pathology (ie, absence of pelvic disease). It typically occurs in the first few years after menarche.
Secondary (congestive): Secondary dysmenorrhea is diagnosed when symptoms are attributable to an underlying disease, disorder, or structural abnormality either within or outside the uterus.
Pathogenesis
It is thought to be due to a release of prostaglandins and leukotrienes in the menstrual fluid, which in turn produces vasoconstriction in the uterine vessels, causing the uterine contractions which produce the pain. The prostaglandin release may also be responsible for gastrointestinal disturbance which may occur in association with dysmenorrhoea.
Risk factors
The following risk factors have been associated with more severe episodes of dysmenorrhea:
- Earlier age at menarche
- Long menstrual periods
- Heavy menstrual flow
- Smoking
- Positive family history
Obesity and alcohol consumption were found to be associated with dysmenorrhea in some (not all) studies. Physical activity and the duration of the menstrual cycle do not appear to be associated with increased menstrual pain.
Incidence
Dysmenorrhea may affect more than half of menstruating women, and its reported prevalence has been highly variable.
Primary dysmenorrhea peaks in late adolescence and the early 20s. The incidence falls with increasing age and with increasing parity. The prevalence and severity of Continue reading »
