Dysmenorrean

Dysmenorrean is a term sometimes used to describe painful menstruation, though the standard medical term is dysmenorrhea. It refers to cramps and related symptoms that occur during the menstrual period and can vary in intensity from mild to severe. The word is sometimes encountered as a less common or misspelled variant of dysmenorrhea.

There are two principal types. Primary dysmenorrhea occurs in people with no underlying pelvic disease and is thought to result from menstrual prostaglandin production that causes uterine contractions and reduced blood flow. It often begins within the first few years after menarche and tends to improve with age or after childbirth. Secondary dysmenorrhea is caused by an identifiable pelvic condition, such as endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, or other gynaecological disorders. Secondary dysmenorrhea typically develops later and may be associated with other symptoms or abnormal bleeding.

Common symptoms include crampy lower abdominal pain that may radiate to the back or thighs, along with nausea, vomiting, diarrhea, headaches, or dizziness. Symptoms usually start around the onset of menstruation and are most intense during the first day or two.

Diagnosis is usually clinical, based on history and physical examination. If pain is severe, persistent, or accompanied by abnormal bleeding, fever, or infertility, further evaluation with imaging or laparoscopy may be indicated to identify a secondary cause.

Management focuses on relief of pain and underlying conditions. For primary dysmenorrhea, nonsteroidal anti-inflammatory drugs and hormonal contraceptives are commonly effective. Nonpharmacologic measures such as heat application, regular exercise, and stress management can help. In secondary dysmenorrhea, treatment targets the underlying condition. The condition is generally treatable, though the approach depends on the specific diagnosis.