Dr. Wanwisak Chaichana
Specialist in Obstetrics and Gynecology
Menstrual pain, or dysmenorrhea, is a common issue among women of reproductive age, affecting up to 50% of menstruating women. Of these, approximately 10% experience symptoms severe enough to disrupt their daily activities, such as missing work or school. Even among those who can continue their activities, the quality of their work may decline, increasing the risk of errors or accidents. If left inadequately addressed, menstrual pain can negatively impact mental health, as patients may develop anxiety regarding their symptoms and experience a reduction in work performance.
Dysmenorrhea can be classified into two main types:
This type occurs without any underlying pelvic pathology. The pain is caused by the production of prostaglandins, which induce uterine muscle contractions, resulting in lower abdominal pain.
This type is associated with identifiable pelvic lesions. The severity of symptoms depends on the type and location of the lesions. Secondary dysmenorrhea is relatively common and often accompanied by other symptoms such as heavy menstrual bleeding, infertility, dyspareunia (pain during intercourse), or recurrent pelvic infections. Most patients with secondary dysmenorrhea begin experiencing symptoms several years after the onset of menstruation, typically between the ages of 25 and 30. However, in some cases, particularly among patients with endometriosis, symptoms may start shortly after menarche.
There are various potential causes, including:
A specialist physician will provide consultation, diagnosis, and appropriate treatment based on the underlying cause identified.
The physician will obtain a detailed medical history and perform a thorough physical examination, including a pelvic examination in certain cases. Additional diagnostic tests, such as pelvic ultrasound, may be necessary to detect underlying pathology. In selected cases, diagnostic laparoscopy may be required to determine the cause of menstrual pain. Laparoscopy allows direct visualization of pelvic structures and offers the advantage of both diagnosis and potential treatment of gynecological conditions.
Besides providing education to women of reproductive age about dysmenorrhea, treatment is divided into two main approaches:
For patients with primary dysmenorrhea, most cases can be managed with analgesics that reduce prostaglandin production or with combined oral contraceptive pills. For secondary dysmenorrhea, treatment depends on the type and severity of the detected lesions and is individualized based on each patient’s condition.
If menstrual pain is severe, it is advisable to consult a physician for appropriate evaluation and treatment.
Last Revised:
20 June 2023
