Dysmenorrhoea

Dysmenorrhoea refers to discomfort and pain associated with menstruation. It is considered to be an under reported disorder, but even so occurs in 45 to 90% of woman who are menstruating. As a major cause of a reduced quality of life in women at the age where they are expected to be most productive, dysmenorrhoea remains a problem despite the availability of safe and effective treatments, even in apparently sophisticated western societies.

Two distinct forms of the complaint are recognised, primary and secondary dysmenorrhoea. Primary dysmenorrhoea is where the symptoms occur in the absence of any demonstrable physical abnormalities, while the secondary form is associated with disorders usually involving the pelvic organs. The value of the distinction lies in recognising that secondary dysmenorrhoea is an indication of a separate disease which requires treatment other than simply pain relief using analgesics, and that treatment of the underlying disorder will frequently reduce the problem of pain, or even remove the complaint altogether. Primary dysmenorrhoea, on the other hand, does not require such extensive work up before being treated, and responds very well to well-known, safe and non-invasive treatments. Since the causes and possible management options differ markedly, the two forms of dysmenorrhoea will be discussed separately.

In the vast majority of cases it is neither necessary, nor necessarily wise for a woman to suffer pain for a tenth of her reproductive life, whether she be a year or two past her menarche, or approaching the end of the reproductive period of her life. The taboos and mystique surrounding menstruation may be one reason for such unnecessary suffering. An understanding of the reasons for menstrual pain, that it is a not a "curse" that has to be born stoically, and definitely not a sign of physical or psychological weakness, may help the female reader better manage any such problem. The male reader may benefit by a better understanding of what dysmenorrhoea may mean to a woman.

Primary dysmenorrhoea

Definition and scope

Secondary dysmenorrhoea

Definition and scope of problem