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Primary dysmenorrhea in adult women: Clinical features and diagnosis

Roger P Smith, MD
Andrew M Kaunitz, MD
Section Editor
Robert L Barbieri, MD
Deputy Editor
Kristen Eckler, MD, FACOG


Dysmenorrhea, or painful menstruation, is a common problem experienced by women in their reproductive years. When severe, it interferes with the performance of daily activities, often leading to absenteeism from school, work, and other responsibilities.


For clinical purposes, dysmenorrhea is divided into two broad categories, primary and secondary:

Primary dysmenorrhea refers to the presence of recurrent, crampy, lower abdominal pain that occurs during menses in the absence of demonstrable disease that could account for these symptoms.

Secondary dysmenorrhea has the same clinical features, but occurs in women with a disorder that could account for their symptoms, such as endometriosis, adenomyosis, or uterine fibroids.


Prevalence — In surveys, 50 to 90 percent of reproductive-aged women worldwide describe experiencing painful menstrual periods [1-10]. The majority of these women are young and have primary dysmenorrhea. The prevalence of primary dysmenorrhea decreases with advancing age [11].

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Literature review current through: Nov 2017. | This topic last updated: Mar 09, 2017.
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