Patient's question:
Why does dysmenorrhea occur?Doctor's answer:
Hello: What is your age? Primary dysmenorrhea is generally believed to be attributed to the following reasons: endometrial shedding (membranous dysmenorrhea), uterine hypoplasia, uterine flexion, cervical stenosis, poor posture and constitutional factors, allergic states, and psychological factors, etc.Secondary dysmenorrhea occurs when pelvic organ abnormalities are detected during bimanual examination in dysmenorrheic patients. It is often misdiagnosed as primary dysmenorrhea when local abnormal signs are not yet apparent. Therefore, for dysmenorrhea that begins more than 3 years after menarche, secondary dysmenorrhea should be considered, and further examination is necessary.
The most common cause of secondary dysmenorrhea in young women is endometriosis, which has symptoms extremely similar to primary dysmenorrhea. If the patient has progressive dysmenorrhea or a family history of endometriosis (e.g., the mother or sister has the condition), laparoscopic examination should be performed early to confirm the diagnosis and undergo conservative surgical treatment to preserve fertility.
Additionally, the causes of secondary dysmenorrhea include congenital uterine malformations (including bicornuate uterus, septate uterus, unicornuate uterus, transverse vaginal septum, etc.), pelvic inflammatory disease, adenomyosis, uterine fibroids, uterine polyps, uterine adhesions, cervical stenosis, ovarian cysts, and pelvic congestion syndrome, etc.
In addition to dysmenorrhea, elevated body temperature during menstruation should raise suspicion of pelvic inflammatory disease. Approximately 5% of women with an intrauterine device (IUD) experience dysmenorrhea. If there is no infection, the cause of dysmenorrhea may be IUD irritation of the endometrium, leading to excessive release of prostaglandins (PGs) and excessive uterine muscle contraction.
Women with uterine malformations or complete lower genital tract obstruction may experience cyclic lower abdominal pain.