Diagnosis and initial management of dysmenorrhea.

Amimi S Osayande, Suarna Mehulic
American family physician · 2014 · vol. 89(5) , pp. 341–6 · PMID:24695505 · W75304758
article OA: closed CC0 ⤵ 27 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper reviews dysmenorrhea, defining primary versus secondary causes and recommending imaging and management strategies like NSAIDs or hormonal contraceptives based on suspected pathology.

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Abstract

Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients' quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primary dysmenorrhea is menstrual pain in the absence of pelvic pathology. Abnormal uterine bleeding, dyspareunia, noncyclic pain, changes in intensity and duration of pain, and abnormal pelvic examination findings suggest underlying pathology (secondary dysmenorrhea) and require further investigation. Transvaginal ultrasonography should be performed if secondary dysmenorrhea is suspected. Endometriosis is the most common cause of secondary dysmenorrhea. Symptoms and signs of adenomyosis include dysmenorrhea, menorrhagia, and a uniformly enlarged uterus. Management options for primary dysmenorrhea include nonsteroidal anti-inflammatory drugs and hormonal contraceptives. Hormonal contraceptives are the first-line treatment for dysmenorrhea caused by endometriosis. Topical heat, exercise, and nutritional supplementation may be beneficial in patients who have dysmenorrhea; however, there is not enough evidence to support the use of yoga, acupuncture, or massage.

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Condition tags

dysmenorrheaendometriosisadenomyosisdyspareunia

MeSH descriptors

Anti-Infective Agents Contraceptives, Oral, Hormonal Disease Management Dysmenorrhea Dysmenorrhea Exercise Therapy Anti-Infective Agents Contraceptives, Oral, Hormonal Dysmenorrhea Exercise Therapy Female Humans Physical Examination Prognosis

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References (25)

Cited by (27)

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License: CC0 · commercial use OK