Dysmenorrhea (pain during periods) is a common problem that affect women. Primary dysmenorrhea is menstrual pain with no underlying medical cause. Secondary dysmenorrhea is menstrual pain that results from structural abnormalities or medical conditions of the reproductive system.
A person who has period pain due to primary dysmenorrhea may be able to treat the symptoms with over-the-counter (OTC) pain medication. However, if a person is having menstrual pain that OTC medications do not relieve, it is essential to contact a doctor to check for causes of secondary dysmenorrhea.
Primary dysmenorrhea is menstrual pain due to natural contraction of the uterus during menstruation. Secondary dysmenorrhea results from a structural problem with the reproductive organs in the pelvic area or from a medical condition such as endometriosis, uterine fibroids, or pelvic inflammatory disease (PID).
Causes of primary and secondary dysmenorrhea
Period pain is the most common menstrual symptom. An estimated 50% to 90% of people who menstruate experience primary dysmenorrhea.
long or heavy periods
smoking
early onset of menstruation
high levels of stress
Secondary dysmenorrhea
Secondary dysmenorrhea happens because of an underlying medical condition or a structural problem with the reproductive organs.
According to the American College of Obstetricians and Gynecologists, the most common cause is endometriosis, a condition in which tissue similar to the inner lining of the uterus grows outside the uterus.
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At least two-thirds of adolescents who have dysmenorrhea that does not respond to treatment will receive an endometriosis diagnosis during a laparoscopic exam.
Other potential causes of secondary dysmenorrhea include:
Uterine fibroids: noncancerous growths in the uterus
Ovarian cysts: fluid-filled sacs on the ovaries
PID: an infection of the reproductive organs
Pelvic adhesions: scar tissue that binds organs together
Congenital uterine anomalies: structural abnormalities of the uterus or vaginal canal that are present from birth
Intrauterine devices (IUDs): particularly copper IUDs
Symptoms of primary and secondary dysmenorrhea
Primary dysmenorrhea
The main symptomTrusted Source of primary dysmenorrhea is cramping in the lower abdomen, often starting a few days before the onset of menstruation. The pain can range from mild to severe and may radiate to the lower back and upper thighs.
Additional symptoms can include:
nausea and vomiting
diarrhea
headaches
muscle cramps
A significant percentageTrusted Source of adolescents and young adults who menstruate miss school or work each month because of debilitating period pain.
Secondary dysmenorrhea
While the symptoms of secondary dysmenorrhea are similar to those of primary dysmenorrhea, they may last longer, may not respond to typical treatments, and may be present outside of a person’s typical monthly menstrual period.
A person with secondary dysmenorrhea may also experience pelvic pain at other times, such as during intercourse, during bowel movements, or during urination.
Other symptoms may include:
heavy menstrual bleeding
bleeding between periods
abnormal vaginal discharge
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