Disease Burden of Dysmenorrhea: Impact on Life Course Potential

Brittany MacGregor, Catherine Allaire, Mohamed A Bedaiwy, Paul J. Yong, Olga Bougie
International journal of women's health · 2023 · vol. Volume 15 , pp. 499–509 · doi:10.2147/ijwh.s380006 · PMID:37033122 · W4362584361
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper describes dysmenorrhea as a common gynecologic condition negatively impacting women's well-being, relationships, education, and career, and potentially leading to chronic pelvic pain.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reviews dysmenorrhea as the most common gynecologic condition, focusing on primary dysmenorrhea and its effects on life course potential through mental/physical wellbeing, quality of life, and downstream risks like chronic pelvic pain via “hyperalgesic priming.” It synthesizes epidemiology and mechanistic evidence on prostaglandin-mediated uterine contractions, possible inflammatory pathways, altered pain processing (including cross-organ sensitization such as bladder sensitivity), and genetic contributions, while also distinguishing primary from secondary dysmenorrhea causes. A key caveat highlighted is the wide variation in reported prevalence due to differing definitions and missing national estimates, and the existence of controversy regarding local versus systemic prostaglandin levels. Relevance to endometriosis: the paper explicitly discusses dysmenorrhea as potentially secondary to pelvic pathology including endometriosis and notes that some individuals with endometriosis may lack MRI myometrial events, though the overall focus is dysmenorrhea disease burden and primary-dysmenorrhea mechanisms.

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Abstract

Dysmenorrhea is the most common gynecologic condition among the female population and has a significant impact on life course potential. It has a widespread impact on a female's mental and physical well-being, with longstanding impairments on quality of life, personal relationships, and education and career attainment. Furthermore, untreated dysmenorrhea can lead to hyperalgesic priming, which predisposes to chronic pelvic pain. Primary dysmenorrhea is pain in the lower abdomen that occurs before or during menses and in the absence of pelvic pathology. One possible mechanism is endometrial inflammation and increased prostaglandin release, resulting in painful uterine contractions. Dysmenorrhea may also occur secondary to pelvic pathology, such as endometriosis, adenomyosis or due to cyclic exacerbation of non-gynecologic pain conditions. A thorough patient evaluation is essential to differentiate between potential causes and guide management. Treatment must be tailored to individual patient symptoms. Pharmacologic management with non-steroidal anti-inflammatory medications and/or combined hormonal contraceptives is most common. Heat therapy, exercise, vitamins and dietary supplements have limited evidence and can be offered for patients seeking non-pharmacologic adjunctive or alternative options. Greater awareness for both health-care providers and patients allows for early intervention to reduce impact on quality of life and life course potential.

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Condition tags

endometriosisadenomyosischronic_pelvic_paindysmenorrhea

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