Current approaches to the diagnosis and management of dysmenorrhea: key points of Russian clinical guidelines and international parallels

Among the most common gynecologic complaints in adolescent girls and women of reproductive age is dysmenorrhea which exerts a substantial negative impact on quality of life, school and work performance, and social participation. Despite its high prevalence, diagnosis and appropriate treatment are commonly delayed, particularly in secondary dysmenorrhea associated with endometriosis. This article provides an analytical overview of current approaches to the diagnosis and management of dysmenorrhea in adolescents and adults, with an emphasis on the 2024 clinical guidelines of the Ministry of Health of the Russian Federation and their comparison with international guidance from the American College of Obstetricians and Gynecologists (ACOG) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG) The review summarizes pathogenetic mechanisms of primary and secondary dysmenorrhea, stepwise clinical and instrumental diagnostic algorithms, age-specific aspects of diagnosing endometriosis in adolescents, and both pharmacological and non-pharmacological treatment tactics. Special attention is paid to differences in the timing and initiation of empirical therapy, the indications for and choice of hormonal agents, the role and optimal use of laparoscopy, and the integration of psychosocial factors into clinical decision-making. The authors conclude that combining the strengths of Russian and international clinical practice is a promising approach to improving the effectiveness and timeliness of care for patients with dysmenorrhea. KEYWORDS: dysmenorrhea, adolescents, endometriosis, ACOG, clinical practice guidelines, NSAIDs, hormonal therapy, menstrual pain. FOR CITATION: Dobrokhotova Yu.E., Kazieva M.D., Narimanova M.R. Current approaches to the diagnosis and management of dysmenorrhea: key points of Russian clinical guidelines and international parallels. Russian Journal of Woman and Child Health. 2026;9(1):25–29 (in Russ.). DOI: 10.32364/2618-8430-2026-9-1-3