What is dysmenorrhea?

Dysmenorrhea is the medical term for pain with menstruation. There are two types of dysmenorrhea: "primary" and "secondary".

Primary dysmenorrhea is common menstrual cramps that are recurrent (come back) and are not due to other diseases. Pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt in the lower abdomen, back, or thighs. Pain can range from mild to severe, can typically last 12 to 72 hours, and can be accompanied by nausea-and-vomiting, fatigue, and even diarrhea. Common menstrual cramps usually become less painful as a woman ages and may stop entirely if the woman has a baby.

Secondary dysmenorrhea is pain that is caused by a disorder in the woman's reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea.

What causes dysmenorrhea (pain of menstrual cramps)?

Menstrual cramps are caused by contractions (tightening) in the uterus (which is a muscle) by a chemical called prostaglandin. The uterus, where a baby grows, contracts throughout a woman's menstrual cycle. During menstruation, the uterus contracts more strongly. If the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain results when part of the muscle briefly loses its supply of oxygen.

How does secondary dysmenorrhea cause menstrual cramps?

Menstrual pain from secondary dysmenorrhea is caused by a disease in the woman's reproductive organs. Conditions that can cause secondary dysmenorrhea include:

  • Endometriosis - A condition in which the tissue lining the uterus (the endometrium) is found outside of the uterus.
  • Adenomyosis – A condition where the lining of the uterus grows into the muscle of the uterus.
  • Pelvic inflammatory disease - An infection caused by bacteria that starts in the uterus and can spread to other reproductive organs.
  • Cervical stenosis - Narrowing of the opening to the uterus.
  • Fibroids (benign tumors) - Growths on the inner wall of the uterus.

What are the symptoms of dysmenorrhea?

  • Aching pain in the abdomen (pain may be severe at times)
  • Feeling of pressure in the abdomen
  • Pain in the hips, lower back, and inner thighs

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