Dysmenorrhoea

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What is Dysmenorrhoea?

Dys - painful; meno - month; rrhea - flow.

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.

Who gets Dysmenorrhoea?

It is one of the most common gynaecologic 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.

Predisposing Factors

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).

The response to prostaglandin inhibitors in patients is a confirmation of this hypothesis. Other factors that may be involved include vasopressin, leukotrienes and prostanglandin E.

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