Dysmenorrhea is defined as crampy pelvic pain associated with menstruation, classified into primary and secondary types. Primary dysmenorrhea is linked to normal pelvic conditions, while secondary dysmenorrhea is due to underlying pelvic pathologies such as endometriosis and uterine fibroids. Key symptoms include crampy pain, low back pain, and gastrointestinal disturbances, with various risk factors and treatment options identified.

1. Dysmenorrhea
Defined as crampy pelvic pain occurring
with or just prior to menses
it has two types:
Primay dysmenorrhea:
is implies pain in the setting of
normal pelvic anatomy and
physiology and normal ovulatory
cycles
Pathophysiology:
- Release of prostaglandins and
leukotrienes into menstrual fluid
- initiating an inflammatory
response and vasopressin mediated
vasoconstriction
Secondary dysmenorrhea:
is pain associated with underlying
pelvic pathology
causes:
endometriosis1-
2- current or history of pelvic
inflammatory disease
3-uterine fibroids
4- adenomyosis leiomyomata
Risk factors of dysmenorrhea :
1- Menarche befor the age of
12years
2- Current age less than 30 y
3-Heavy menses
4- Nulliparity
5-Low body mass index
6- History of sexual abuse
Clinical presentation:
sympatoms::
1-Crampy pelvic pain beginning shortly
before or at the onset of menses and
symptoms typically last from 8 - 72 h
2-low back pain
3-headech
4-diarrhea
5-fatigus
6-nausa and vomiting
laboratory tests:
1-pelvic examination
2-chlamydia cultures or polymerase chain
reaction (PCR)
3-transvaginalpelvic ultrasound
This mind-map is created by Areej Al Mohamadi. Revised & edited By Dr. Arwa M. Amin. The information of the mind-map is based on Chapter 96: Menstruation-Related Disorders, Pharmacotherapy: A
Pathophysiologic Approach, 11e
Joseph T. DiPiro, Gary C. Yee, L. Michael Posey, Stuart T. Haines, Thomas D. Nolin, Vicki Ellingrod

2. Treatment algorithm of Dysmenorrhea
LNG-IUS, levonorgestrel-releasing intrauterine system. MPA:
medroxyprogesterone acetate. NSAIDS: nonsteroidal anti-
inflammatory drugs. CHC: combined hormonal contraceptive.)

3. This mind-map is created by Areej Al Mohamadi. Revised & edited By Dr. Arwa M. Amin. The information of the mind-map is based on Chapter 96: Menstruation-Related Disorders, Pharmacotherapy: A
Pathophysiologic Approach, 11e