Dysmenorrhea is uterine pain with menstruation, commonly called menstrual cramps. Dysmenorrhea has been reported to be significantly increased among mothers and sisters of women with dysmenorrhea. Pathophysiology Primary dysmenorrhea is produced by a high concentration of uterine prostoglandin that stimulates the frequency and strength of uterine contractions, which cause the pain. Secondary dysmenorrhea is caused by the underlying disease. Symptoms or clinical manifestations Colicky, nagging low pelvic pain often radiating into the low back, vulva, perineum and into the inner thighs.
Symptoms can start one to two days before menses or with the start of menstruation.
Secondary dysmenorrhea should be suspected if symptoms occur after age 20. A detailed menstrual history should include the woman's age at onset and the relationship of the onset to menarche. The history should also include the symptoms, their duration and association with the onset of menstruation. Ultrasonography is useful to identify congenital abnormalities or endometriosis. In primary dysmenorrhea the interventions are directed at reducing the uterine prostaglandin levels.