DYSMENORRHEA: CLINICAL MANIFESTATIONS, PATHOGENESIS AND CONTEMPORARY TREATMENT STRATEGIES

Zarina Tillayeva, Islom Mamadiyorov, Davronbek Xojiboyev
2026 · doi:10.5281/zenodo.21096917 · W7166889347
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⚙ AI-generated summary by claude@2026-07, 2026-07-14 ⓘ

This review analyzes dysmenorrhea's clinical features, prostaglandin-driven pathogenesis, and contemporary treatments, emphasizing a combined approach of pathophysiological reasoning, real-world evidence, and artificial intelligence for improved care.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-14 · read from full text ⓘ

This IMRAD-based analytical review synthesizes dysmenorrhea evidence from PubMed-indexed reviews, Cochrane sources, WHO menstrual health materials, ACOG/ESHRE guidance, and regulatory sources (FDA/EMA) to summarize clinical phenotypes, prostaglandin-centered pathogenesis, differential diagnosis, and contemporary treatment strategies, with an implementation perspective for Uzbekistan. It finds that primary dysmenorrhea is mainly driven by increased endometrial production of prostaglandin F2α and prostaglandin E2, leading to myometrial hypercontractility, vasoconstriction, ischemia, and pain, while secondary dysmenorrhea requires evaluation for conditions including endometriosis and adenomyosis. A major caveat is that the paper is an analytical narrative review that synthesizes existing guidance and evidence rather than reporting new primary studies. Relevance to endometriosis: the paper explicitly frames secondary dysmenorrhea evaluation around endometriosis and cites ACOG guidance on dysmenorrhea and endometriosis in adolescents, though its main focus is dysmenorrhea pathogenesis and management strategies broadly, including when secondary causes are suspected.

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Abstract

Dysmenorrhea is one of the most frequent gynecological complaints among adolescents and women of reproductive age. It is often normalized as a routine part of menstruation, yet recurrent menstrual pain may substantially reduce educational participation, work productivity, sleep quality, mental well-being, and social functioning. This article provides an IMRAD-based analytical review of dysmenorrhea with emphasis on clinical phenotypes, prostaglandin-centered pathogenesis, differential diagnosis, contemporary treatment strategies, real-world evidence, artificial intelligence, pharmacovigilance, and implementation perspectives for Uzbekistan. Evidence was synthesized from PubMed-indexed reviews, Cochrane evidence, WHO menstrual health materials, ACOG and ESHRE guidance, and regulatory sources from FDA and EMA on real-world evidence and AI-enabled health technologies. The review highlights that primary dysmenorrhea is mainly driven by increased endometrial production of prostaglandin F2α and prostaglandin E2, which induce myometrial hypercontractility, vasoconstriction, ischemia, and pain. Secondary dysmenorrhea requires active evaluation for endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, and structural anomalies. NSAIDs, hormonal therapy, heat therapy, exercise, patient education, and timely referral form the core of modern management. The article argues that modern dysmenorrhea care should combine pathophysiological reasoning with real-world evidence, patient-reported outcomes, pharmacovigilance, and ethically governed artificial intelligence. Such an approach is especially important for health systems developing electronic prescriptions, registries, and digital clinical decision support. For Uzbekistan, structured menstrual health documentation may create a foundation for safer analgesic use, earlier detection of secondary dysmenorrhea, and locally relevant research.
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DYSMENORRHEA: CLINICAL MANIFESTATIONS, PATHOGENESIS AND CONTEMPORARY TREATMENT STRATEGIES Authors/Creators - 1. Termez University of Economics and Service Description Dysmenorrhea is one of the most frequent gynecological complaints among adolescents and women of reproductive age. It is often normalized as a routine part of menstruation, yet recurrent menstrual pain may substantially reduce educational participation, work productivity, sleep quality, mental well-being, and social functioning. This article provides an IMRAD-based analytical review of dysmenorrhea with emphasis on clinical phenotypes, prostaglandin-centered pathogenesis, differential diagnosis, contemporary treatment strategies, real-world evidence, artificial intelligence, pharmacovigilance, and implementation perspectives for Uzbekistan. Evidence was synthesized from PubMed-indexed reviews, Cochrane evidence, WHO menstrual health materials, ACOG and ESHRE guidance, and regulatory sources from FDA and EMA on real-world evidence and AI-enabled health technologies. The review highlights that primary dysmenorrhea is mainly driven by increased endometrial production of prostaglandin F2α and prostaglandin E2, which induce myometrial hypercontractility, vasoconstriction, ischemia, and pain. Secondary dysmenorrhea requires active evaluation for endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, and structural anomalies. NSAIDs, hormonal therapy, heat therapy, exercise, patient education, and timely referral form the core of modern management. The article argues that modern dysmenorrhea care should combine pathophysiological reasoning with real-world evidence, patient-reported outcomes, pharmacovigilance, and ethically governed artificial intelligence. Such an approach is especially important for health systems developing electronic prescriptions, registries, and digital clinical decision support. For Uzbekistan, structured menstrual health documentation may create a foundation for safer analgesic use, earlier detection of secondary dysmenorrhea, and locally relevant research. Files Tillayeva 133-148 NURSING.pdf Files (642.9 kB) | Name | Size | Download all | |---|---|---| | md5:d6002687b4a44518c911dc934a76aa13 | 642.9 kB | Preview Download | Additional details References - 1. World Health Organization. Menstrual health. Geneva: WHO; 2026. Available from: https://www.who.int/news-room/fact-sheets/detail/menstrual-health - 2. Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean J Fam Med. 2022;43(2):101-108. doi:10.4082/kjfm.21.0103 - 3. Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;(7):CD001751. doi:10.1002/14651858.CD001751.pub3 - 4. American College of Obstetricians and Gynecologists. Committee Opinion No. 760: Dysmenorrhea and endometriosis in the adolescent. Obstet Gynecol. 2018;132(6):e249-e258. doi:10.1097/AOG.0000000000002978 - 5. Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009. doi:10.1093/hropen/hoac009

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