Dysmenorrhea is a gynecological condition, which affects between 45 and 95% of women of reproductive age. In fact, it is a condition that not all who suffer from it are aware of it and consider that it may be normal.

In addition to that, there is still no complete understanding of the pathology. It has an intrinsic relationship with Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Syndrome (PMDS) , since these same symptoms are those that are extrapolated to patients suffering from dysmenorrhea.

What is dysmenorrhea?

In the Medical Journal of the Autonomous University of Sinaloa (REV MED UAS), they developed an article on Dysmenorrhea , where they explain that it is a difficult menstruation classified into primary and secondary according to its severity.

It is a combination of somatic discomfort and changes in mood and even behavior. The pain is described as cramping and colicky in type and may radiate to the lumbosacral region or the anterior aspect of the thigh.

The first dysmenorrhea is one that presents pain during the menstrual days, but does not present associated pelvic pathology. Secondary if there is underlying pelvic pathology (fibroids, adenomyosis, endometriosis, pelvic inflammatory disease).

The distinction between them can be appropriated from different characteristics, especially from when the symptoms begin to occur.

Causes of dysmenorrhea

Through all the studies carried out based on this pathology, there are different causes that can trigger it. We will mention and explain them below.

hormonal alteration

Dysmenorrhea involves many hormonal factors, which are directly related to the different menstrual processes.

In an article from the Continuing Education Program in Extrahospital Pediatrics , they explain that it is currently accepted that dysmenorrhea occurs due to an increase in uterine production of prostaglandins , concomitant with the drop in ovarian steroid levels at the time of delivery . menstruation.


In the Society of Obstetrics and Gynecology of the Province of Buenos Aires, they state that endometriosis is the main cause of secondary dysmenorrhea. It is considered in patients with persistent symptoms.

In the appearance of adolescent endometriosis, it happens that the lesions are usually clear or red and difficult to identify. It is considered a chronic disease with the potential to progress if not treated correctly.

uterine fibroid

Fibroids are benign tumors that are located in the uterus. Hormones such as estrogen and progesterone seem to make them grow, since the female body produces more during the time that she has her menstrual periods.

The presence of these causes increased bleeding, pelvic pain and prolongation of the period.

Congenital malformation

Genital or uterine congenital abnormalities and malformations lead to dysmenorrhea. These anomalies, sometimes in fact, can be identified by the pains that occur during menstrual periods or the prolongation of them. They also present pain during sexual intercourse and the following can be identified:

  • unicornuate uterus
  • bicornuate uterus
  • didelphys uterus
  • septate uterus
  • vaginal agenesis


The fibroid is a benign mass that can vary in size and that leads to the uterus presenting symptoms such as heavy bleeding, prolonged period and pelvic pain, although in some cases it presents asymptomatically.

Dysmenorrhea can be directly associated with the presence of fibroids and is what leads to dysmenorrhea being secondary.

Pelvic inflammatory disease

In the research paper on Chronic Pelvic Pain , it arises from pelvic inflammatory disease. This is usually caused by recurrent episodes of urinary tract infections and consequently pain from adhesions or fistulas develop.

At the time of menstrual periods and the inflammation that the body has, it constitutes pain caused by nerve damage by the pathogenic agents that produce the infection.


A history of sexually transmitted infections (such as chlamydia and gonorrhea) and also a history of pelvic inflammatory diseases may be a cause associated with the development of dysmenorrhea.

abnormal pregnancy

In the article on Dysmenorrhea they explain that: “The pain that is associated with vaginal bleeding may be due to a complicated early pregnancy, either with a threatened abortion, miscarriage or ectopic pregnancy”

symptoms of dysmenorrhea

Dysmenorrhea, although it is a painful period as we mentioned at the beginning of the article, has certain symptoms that can help us identify it and seek competent medical assistance so that we can obtain the appropriate treatment. These symptoms are listed below and briefly described.

Pain in the lower abdomen

One of the main symptoms is this characteristic pain. It begins to appear between 45 and 24 hours before the menstrual period begins.

It usually disappears after the bleeding begins, between the first and second day of it. These pains can also include the lower back, lower back pain and pain in the leg area. They may be cramping or intermittent cramp-like pain.


Headache is a symptom that can appear before, during and even after. Sometimes it is an isolated pain by zones and other times it is not, covering the entire cranioencephalic area. It is usually accompanied by a feeling of fatigue and its intensity is variable.

nausea and vomiting

In 89% of cases of dysmenorrhea this symptom occurs. It can be a consequence of the previously described pain or be an isolated and independent symptom.


In many cases, stomach affection is common every time the menstrual period occurs. It is characterized by being during the first or last two days of the menstrual period and is rarely painful or accompanied by cramps.


Muscle fatigue and even a feeling of pain in the bones is quite constant. Before the start of the period, during and rarely after it.

Most of the discomfort is concentrated in the extremities and joints. There is muscle inflammation and discomfort that limits the willingness to continue with the daily routine.


It also happens in many cases that at the moment the menstrual period begins to lower the tension and certain symptoms are triggered that can cause fainting.

It is advisable to eat something sweet and raise your legs to approximately 45°, to counteract this discomfort.

treatment for dysmenorrhea

There are different treatments available for dysmenorrhea. Studies still do not give exact information on the symptoms that it presents and what specific pathology is triggered, but each of the following treatments has helped to control them, taking into account that each body is different.

It is important to mention that to consume contraceptives or medications it is advisable to consult with a medical professional.

Contraceptive use

The use of oral contraceptives is considered a protective element for dysmenorrhea. These inhibit ovulation and the production of prostaglandins.

The reduction of progesterone levels avoids an important step in the production of prostaglandins and for this very reason dysmenorrhea.

anti-inflammatory drugs

The use of non-steroidal anti-inflammatory drugs is above all a treatment applied in emergency cases. It can in fact be added to contraceptive treatment and also works by inhibiting the production of prostaglandins.

They also help relieve pain.

Balanced diet

A diet rich in calcium can help to reduce the symptoms of dysmenorrhea.

A low-fat diet helps lower estrogen levels, as does increasing fiber-rich foods. Drinking plenty of water also helps to eliminate toxins from the body.

regular physical exercise

Armor M and collaborators developed an article for the Blog called Cochrane , where they explain how high or low intensity physical exercises provide an incredible reduction in menstrual pain, compared to women who do not have any type of physical activity in their daily routine.

Consult the doctor if necessary

The medical evaluation allows the identification of whether it is primary or secondary dysmenorrhea and the severity of the symptoms, for this reason it is important to carry it out to detect underlying pathologies and adequate treatments, so that life is not affected every time it is time for the menstrual period. .

We recommend attending a medical consultation and always taking care of our health. Never minimize your ailments and always clarify your doubts.

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