Also known as
# Secondary dysmenorrhea is also known as painful or difficult menstruation.
Description
# Secondary dysmenorrhea is related to the presence of pelvic lesions secondary to organic pelvic disease such as endometriosis, salpingitis, PID (pelvic inflammatory disease), postsurgical adhesions, etc. Secondary dysmenorrhea begins a few days before menstruation and lasts several days after the onset of flow. Often, it is lateralized to one side, and it does not characteristically peak and diminish as clearly or quickly as primary dysmenorrhea. Its onset is later in life, in women who have not had primary dysmenorrhea; however, it can be superimposed onto a pre-existing case of primary dysmenorrhea. An intrauterine device (IUD) may cause secondary dysmenorrhea.
Causes
# Endometriosis
# Pelvic inflammation
# Adenomyosis
# Uterine myoma
# Ovarian cyst
# Pelvic congestion
# IUD
# Uterine polyp
# Uterine malformation
# Cervical stenosis
Symptoms
# Pain may be continuous or intermittent
# Pelvic tenderness
# Nausea and/or vomiting
# Sweating, headaches, rapid heartbeat
# Diarrhea
# Tremulousness
Diagnosis
History and physical examination by the health care provider will differentiate between functional dysmenorrhea and those rare cases associated with a medical condition. Younger adolescents who have not become sexually active usually do not require a pelvic examination.
Treatment
Treatment of underlying disease:
# Pain relievers: aspirin, ibuprofen, naproxen, acetaminophen
# Birth control pills
# Surgery is not usually helpful in alleviating pain
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