Nanda Books

Dysmenorrhea is the medical term for pain with menstruation. There are two types of dysmenorrhea: "primary" and "secondary". Dysmenorrhea is often defined simply as menstrual pain, or at least menstrual pain that is excessive.

Menstrual pain is often used synonymously with menstrual cramps, but the latter may also refer to menstrual uterine contractions, which are generally of higher strength, duration and frequency than in the rest of the menstrual cycle.

Difference Between Primary Dysmenorrhea and Secondary Dysmenorrhea

Primary dysmenorrhea is common menstrual cramps that are recurrent and are not due to other diseases. Cramps usually begin one to two years after a woman starts getting her period. Primary dysmenorrhea is the most common type of dysmenorrhea, affecting more than 50% of women, and quite severe in about 15%. Primary dysmenorrhea is more likely to affect girls during adolescence. Fortunately for many women, the problem eases as they mature, particularly after a pregnancy. Pain usually begins 1 or 2 days before or when menstrual bleeding starts and is felt in the lower abdomen, back, or thighs and can range from mild to severe. Pain can typically last 12 to 72 hours and can be accompanied by nausea, vomiting, fatigue, and even diarrhea.

Secondary dysmenorrhea is menstrual pain that is generally related to some kind of gynecologic disorder. Secondary dysmenorrhea is pain that is caused by a disorder in the woman's reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection. Most of these disorders can be easily treated with medications or surgery. Secondary dysmenorrhea is more likely to affect women during adulthood. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea.

Symptoms of Dysmenorrhea

A medical history and pelvic exam alone may provide enough information for the doctor to determine whether the cramps are caused by primary dysmenorrhea. In primary dysmenorrhea, the pelvic exam is normal between menses. Examination during menses may produce discomfort but no abnormal findings.

In secondary dysmenorrhea, there may be findings on physical exam. Additional tests may include radiologic studies (including ultrasound) and laparoscopy (involves inserting a tiny, flexible lighted tube through a small incision just below the navel to view the internal abdominal and pelvic organs).