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Dysmenorrhoea refers to pain occurring before or during menstruation or both. It is classified into primary and secondary. Primary dysmenorrhoea occurs when pelvic anatomy and ovarian function are normal and no organic cause can be found for pain.
Secondary dysmenorrhoea describes pain due to pelvic pathology. It can occur at any age but most commonly observed in women 20-45 yrs of age.
It is one of the most common gynecologic complaints in young women, affecting approximately 40 – 70% of women of reproductive age, with 10% of women describing severe symptoms. The true incidence is however difficult to establish due to inconsistent definition.
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The exact mechanisms of primary dysmenorrhoea are unclear, but pain has been associated with high levels of prostaglandin in the uterus. This high prostaglandin levels increases uterine muscle contraction, leading to reduction in blood flow to uterine muscles (a sort of uterine angina).
What are the symptoms of Dysmenorrhoea (Period Pain, Menstrual Cramps)?
Primary dysmenorrhoea usually coincides with the start of menstruation. The initial onset is usually shortly after first menses.
Secondary dysmenorrhoea is associated with a later age of onset, after years of pain free menses and the patient is usually over 30 years of age. The pain begins as a dull pelvic ache 3 – 4 days before the menses and becomes more severe during menstruation. Other symptoms that may be associated with secondary dysmenorrhoea include: pain during sex, irregular cycles, heavy bleeding, bleeding in between cycles or after sex. It should be noted that all these symptoms can also be caused by other gynecological conditions.