Dismennorea - Causes and Symptoms

Definition

Dysmenorrhea is a uterine pain that occurs a few days before the onset of menstruation. It is one of the most common symptoms of premenstrual syndrome, so it may be associated with headache, nausea, constipation or diarrhea and low back pain. In general, dysmenorrhoea reaches its maximum intensity 24 hours after the appearance of menstrual flow and can last for 2-3 days. It manifests as an intense pain in the lower abdomen; it is usually sharp, but it can also be crampy, dull and constant.

Dysmenorrhea can be primary (more frequent) or secondary.

Primary dysmenorrhea is not related to any gynecological disease; symptoms begin just after the menarche (first menstruation) or during adolescence, diminish over the years and may disappear after the first pregnancy. It is a symptom attributable to hormonal changes due to ovulatory cycles and excessive production of prostaglandins, which cause spastic and painful contractions of the uterus during the first two days of the menstrual flow. Within certain limits, therefore, in a young woman the pain is to be considered normal and physiological. Risk factors for more intense symptoms include: early age of menarche, prolonged or intense menstrual flows, smoking and a family history of dysmenorrhea. Also anxiety related to menstruation and lack of exercise can negatively affect dysmenorrhoea.

Secondary dysmenorrhea, on the other hand, usually arises more betrayed than the primary, occurs throughout the period of the menstrual flow and is due to other diseases or pelvic abnormalities. The most common causes are endometriosis, inflammation of the tubes or ovaries, uterine adenomyosis, the use of an intrauterine device as a method of contraception, and the presence of fibroids and polyps of the uterus or cervix. Less frequent disturbances that cause this symptom include congenital malformations (eg narrowing of the cervix, malpositioned uterus etc.), pelvic inflammatory disease, cysts and ovarian tumors.