Dysmenorrhea: Overview and Risk Factors

Dysmenorrhea is the technical term for menstrual cramps that are severe enough to interfere with a woman's normal functioning. It is the most common gynecologic complaint, affecting at least 50 percent of menstruating women. One to 2 percent of women experience severe, incapacitating symptoms.

Primary dysmenorrhea -- menstrual pain that occurs in the absence of underlying disease -- is thought to be related to the release of hormones called prostaglandins during menstruation, which can cause excessive contractions of the uterus. The pain is most severe at the start of the menstrual period and lasts 12 to 72 hours. It is wavelike and cramping in nature and may spread to the back. Accompanying symptoms may include nausea, vomiting, diarrhea, fatigue, headache, and shortness of breath.

Secondary dysmenorrhea is caused by pelvic diseases, such as endometriosis, fibroids, pelvic infections, prior surgery, or cervical stenosis. The pain of secondary dysmenorrhea usually begins earlier in the menstrual cycle and continues beyond the end of the menstrual period. Additional symptoms may be present depending on the underlying disease.

Risk Factors

The following factors are associated with risk for primary dysmenorrhea. Risk factors for secondary dysmenorrhea depend on the underlying disease.

• Age: The most intense, disabling symptoms occur during adolescence and typically decrease with age.
  
• Sedentary lifestyle

Factors that decrease the risk of dysmenorrhea include use of oral contraceptive pills and previous pregnancies.