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Definition
Dysmenorrhea literally means painful menstruation. Many women get some discomfort during menstruation. It is known as dysmenorrhea if the pain is severe and the woman has to take bed–rest and analgesic.

Types of Dysmenorrhea Primary (Spasmodic)
This is the commonest type of dysmenorrhea. In primary dysmenorrhea there is no certain pelvic pathology involved.
Age
Primary dysmenorrhea is predominantly confined to adolescent girls, 15–18 years of age. It usually appears within 2 years of menarche. There may be a family history of dysmenorrhea in the mother or sister.
Clinical Features of Dysmenorrhea Causes of Pain Treatment of Dysmenorrhea
Measures include improvement of general health and simple psychotherapy in terms of explanation and assurance. It should be explained to young girls that menstruation is a physiological phenomenon and not a disease. The girl should be taught the hygiene of menstruation. The patient should be reassured that the pain is short lived.

She may use a hot water bottle for fomentation of the lower abdomen. Usual activities including sports are to be continued. During period, bowel should be kept empty and mild analgesics and antispasmodics may be prescribed. With these simple measures, the pain is relieved in majority.
In severe cases Drugs
The drugs used are The suitable candidates for oral contraception are patients Surgery Secondary (Congestive) Dysmenorrhea
Secondary dysmenorrhea is normally considered to be period–associated pain occurring in the presence of pelvic pathology.
Age
The patients are usually in thirties; more often parous (have had previous deliveries) and unrelated to any social status.
Clinical Features of Secondary Dysmenorrhea
The pain is dull, situated in the back and in front without any radiation. It usually appears 3–5 days prior to the period and relieves with the start of bleeding. The onset and duration of pain may vary. There is no systemic discomfort unlike primary dysmenorrhea. The patients may have got some discomfort even in between periods. There are symptoms of associated pelvic pathology. Abdominal and vaginal examinations usually reveal a lesion. At times, the lesion is revealed by laparotomy or laparoscopy.
Cause Of Pain
The pain may be related to increased vascularity in the pelvic organs. Common lesions are–chronic pelvic inflammatory disease, pelvic endometriosis, adenomyosis, uterine fibroid, endometrial polyp, IUCD etc.

Treatment of Secondary Dysmenorrhea
The type of treatment depends on the severity, age and parity of the patient. Analgesics provide temporary relief.