Causes, incidence, and risk factors

Primary dysmenorrhea in adolescents usually begins 2 to 3 years following the onset of menses. It consists of crampy lower abdominal pain that generally begins several hours prior to the onset of a menstrual period, but may begin as much as 1 or 2 days in advance.

The pain lasts 1 or more days into the period and then subsides. Pain may be mild to severe, and may be associated with nausea and vomiting and changes in bowel habits (either constipation or diarrhea). Primary dysmenorrhea is caused by prostaglandin-induced uterine contractions.

Dysmenorrhea is a common gynecological complaint in adolescents, but the majority of cases are not associated with a disease, and the physical examination is normal. Dysmenorrhea has been reported to be significantly increased among mothers and sisters of women with dysmenorrhea.

Abnormal conditions associated with secondary dysmenorrhea include endometriosis, pelvic inflammatory disease, vaginal agenesis, and others. Secondary dysmenorrhea most commonly begins in women in their 20s. Increasing frequency of sexually transmitted diseases among adolescents has increased the percentage of dysmenorrhea cases associated with disease.

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