Prostaglandins are chemicals that are formed in the lining of the uterus during menstruation. These prostaglandins cause muscle contractions in the uterus, which cause pain and decrease blood flow and oxygen to the uterus.
Similar to labor pains, these contractions can cause significant pain and discomfort. Prostaglandins may also contribute to the nausea and diarrhea that some women experience.
The pain of dysmenorrhea is crampy and usually located in lower abdomen above the pubic bone (the suprapubic region); some women also have severe pain in the back or thighs. The pain usually begins just before or as menstrual bleeding begins, and gradually diminishes over one to three days. Pain usually occurs intermittently, ranging from mild to disabling.
Other symptoms that may accompany cramping include nausea, diarrhea, dizziness, fatigue, headache, or a flu-like feeling.
The diagnosis of dysmenorrhea is based upon on her medical history and physical examination.
On physical examination patient with dysmenorrhea should have a complete abdominal and pelvic examination. During the examination, the healthcare provider will observe and feel the size and shape of the vagina, cervix, uterus, and ovaries. An internal pelvic examination may not be necessary in adolescent girls.
In some women, pelvic ultrasound (performed vaginally if possible) can be useful in determining if conditions such as uterine fibroids, adenomyosis, or endometriosis are present.
There are a number of treatments available for women with dysmenorrhea.