Primary dysmenorrhoea : a common clinical problem

Abstract

In writing an essay on the condition of primary dysmenorrhoea, one must first and foremost ensure that the reader knows exactly what it is he is reading about. This seemingly superfluous statement is deliberate, and provoked by the apparently infinite variety of definitions attached to this condition. Primary dysmenorrhoea is a distinct clinical entity, and is best defined as a pain which is of uterine origin and directly due to menstruation. It has variously been referred to as true, spasmodic, intrinsic, essential and functional dysmenorrhoea, but I feel that the adjective "primary" is best suited to define a condition which has to be distinguished from two other conditions, namely: 1. Secondary dysmenorrhoea, or dysmenorrhoea following pathologic conditions in the reproductive organs. -- 2. Congestive dysmenorrhoea, or dysmenorrhoea in which the pain arises in tissues outside the uterus. -- This definition is often ignored in some countries, where primary dysmenorrhoea refers to dymenorrhoea dating from the menarche, as distinct from dysmenorrhoea developing after a phase of painless cycles. However, if one is to adopt this latter classificaton, it is probable that very few cases of primary dysmenorrhoea will be diagnosed; it is my clinical impression that dysmenorrhoea dating from the menarche is very uncommon.