Painful menstruation is called dysmenorrhea (dis-meh-nuh-REE-uh). Primary dysmenorrhea occurs during menstruation and is usually caused by the overproduction of prostaglandins, chemicals that cause the muscles of the uterus to contract. Problems with primary dysmenorrhea usually appear with the onset of menstruation at adolescence. One study found that 67% of adolescents experienced some degree of dysmenorrhea (Scharma et al., 2008). The symptoms are generally most noticeable during the first few days of a woman’s period and include abdominal aching and/or cramping. Some women also experience nausea, vomiting, diarrhea, headache, dizziness, fatigue, irritability, or nervousness.
Secondary dysmenorrhea occurs before or during menstruation and is characterized by constant and often spasmodic lower abdominal pain that typically extends to the back and thighs. The symptoms are often similar to those of primary dysmenorrhea and are caused by factors other than prostaglandin production; possible causes include the presence of an intrauterine device (IUD), pelvic inflammatory disease (chronic infection of the reproduc
endometriosis
A condition in which uterine tissue grows on various parts of the abdominal cavity.
tive organs), benign uterine tumors, obstruction of the cervical opening, and endometriosis (en-doh-mee-tree-OH-sis). Endometriosis, which affects up to 10% of premenopausal women in the United States (including adolescents), occurs when endometrial-like tissue implants in the abdominal cavity (Bulun, 2009). The implanted tissue often adheres to other tissue in the pelvic cavity, reducing mobility of the internal structures while engorging with blood during the proliferative phase. The engorged tissues and adhesions can cause painful menstruation, lower backache, and pain from pressure and movement during intercourse. Once the cause of secondary dysmenorrhea has been diagnosed, appropriate treatment can begin (Propst & Laufer, 1999).
amenorrhea
The absence of menstruation.