Dysmenorrhea
Dysmenorrhea is painful menstruation, characterized by crampy lower-abdominal or pelvic pain occurring before or during menses, often accompanied by back pain, leg pain, nausea, diarrhea, or headache.
Primary dysmenorrhea arises from prostaglandin-mediated myometrial contractions and ischemia in the absence of pelvic pathology. It typically begins within six to twelve months of menarche. Secondary dysmenorrhea stems from identifiable pathology: most commonly endometriosis and adenomyosis, and also uterine fibroids, ovarian cysts, pelvic inflammatory disease, cervical stenosis, or intrauterine devices.
RRM clinicians treat dysmenorrhea as a diagnostic signal of underlying pathology, not a symptom to suppress with combined oral contraceptives. Suppressive hormonal medications mask disease; they do not cure it. First-line pain management targets prostaglandin synthesis via NSAIDs. Persistent or severe dysmenorrhea triggers a thorough workup: cycle charting (Creighton Model FertilityCare System, FEMM), pelvic ultrasound, and laparoscopy with directed excision of endometriosis when pathology is confirmed. Restorative excision of underlying endometriosis addresses the anatomical source and can resolve long-standing dysmenorrhea.
This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.