Usually develops one to two years after menarche. Secondary - caused by an underlying disease, infection or gynecological problem. These include endometriosis, PID, uterine fibroids, functional ovarian cysts or intrauterine device. May appear years after normal menstruation. Also can be associated with nausea, vomiting, diarrhea, urinary frequency, irritability, depression, chills and abdominal bloating.
Symptoms can start one to two days before menses or with the start of menstruation.
Ultrasonography is useful to identify congenital abnormalities or endometriosis. Primary - directed at reducing the uterine prostaglandin levels. Secondary - usually aimed at treating the underlying cause. Often includes surgery. Obtain a detailed medical history.