Dysmenorrhea

Dysmenorrhea is painful menstruation, usually involving cramping in the lower abdomen before or during menstrual bleeding. It is classified as primary when no pelvic disorder causes it and secondary when an underlying condition does.

Prostaglandins: Prostaglandins are lipid compounds that act as local signaling molecules, influencing inflammation, smooth-muscle contraction, and pain. Elevated uterine prostaglandin activity can intensify contractions and pain in primary dysmenorrhea.
Menstruation: Menstruation is the periodic shedding of the uterine lining through the vagina when pregnancy has not occurred. Dysmenorrhea is pain associated with this recurring bleeding process.
Menstrual cycle: The menstrual cycle is the recurring sequence of hormonal and reproductive changes that prepares the body for possible pregnancy. Pain timing within the cycle helps characterize dysmenorrhea.
Mittelschmerz: Mittelschmerz is one-sided lower abdominal pain associated with ovulation, usually occurring midway through the menstrual cycle. Its mid-cycle timing distinguishes it from pain centered around menstrual bleeding.
Uterine contraction: Uterine contraction is the tightening of the muscular wall of the uterus. Strong contractions can reduce uterine blood flow and contribute to cramping pain.
Primary dysmenorrhea: Primary dysmenorrhea is menstrual pain without an identifiable pelvic disorder, often beginning in adolescence. It is the common form linked to menstrual prostaglandin activity rather than another disease.
Pelvic examination: A pelvic examination assesses the external and internal reproductive organs by inspection and touch. It may help identify causes when symptoms suggest secondary dysmenorrhea.
Chronic pelvic pain: Chronic pelvic pain is persistent or recurrent pain perceived in the pelvic region, typically lasting for months. Dysmenorrhea is cycle-linked, while chronic pelvic pain may persist between periods.
Nociception: Nociception is the nervous system’s detection and processing of potentially tissue-damaging stimuli. It describes how uterine signals become perceived as menstrual pain.
Secondary dysmenorrhea: Secondary dysmenorrhea is menstrual pain caused by an identifiable underlying pelvic or reproductive condition. A new, worsening, or persistent pattern can reflect this distinct form.

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