Part of “CHAPTER 96 – DISORDERS OF MENSTRUATION, OVULATION, AND SEXUAL RESPONSE“

Dysmenorrhea is the most common of all gynecologic disorders, affecting perhaps 50% of postpubescent women.202 Dys-menorrhea is classified as primary or secondary. In primary dysmenorrhea, no pathologic cause for the pain can be identified. It occurs only in ovulatory menstrual cycles and may be more prevalent in women with the premenstrual syndrome (see Chap. 99). The pathogenesis of the dysmenorrhea is related to the prostaglandins that are released from the endometrium just before and during menstruation. The prostaglandins apparently cause dysmenorrhea by inducing painful, exaggerated uterine contractions with myometrial ischemia. Associated systemic symptoms may include nausea, diarrhea, headache, and emotional changes.