Dysmenorrhoea or “painful periods” is the most common of all gynaecological symptoms. It is generally described as a crampy lower abdominal pain, which starts at the onset of menstruation. It can be classified as either:
The risk factors for primary dysmenorrhoea include:
The typical description of dysmenorrhoea is lower abdominal or pelvic pain, which can radiate to lower back or anterior thigh. Pain is crampy in nature. It usually lasts for 48-72 hours around the menstrual period, and is characteristically worst at the onset of menses. The pain can be associated with other symptoms, such as; malaise, nausea, vomiting, diarrhoea, dizziness. Abdominal and pelvic examinations (including speculum examination of cervix) are performed but are usually unremarkable. Uterine tenderness may be present.
No investigations are specific to primary dysmenorrhoea and therefore the work up is focused on ruling out underlying pathology.
Diagnostic Laparoscopy may be warranted to diagnose underline mild Endometriosis as a cause for Dysmenorrhea.
If the patient is at high risk of a sexually transmitted infection, then a high vaginal swab and endocervical swabs are indicated to screen for underlying infection.
If on examination a pelvic mass is palpated, a transvaginal ultrasound scan (TVS) should be performed to investigate further.