Dysmenorrhea (or dysmenorrhoea) is a medical condition characterized by severe uterine pain during menstruation. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication.

Dysmenorrhea refers to the syndrome of painful menstruation. Primary dysmenorrhea occurs in the absence of pelvic pathology, whereas secondary dysmenorrhea results from identifiable organic diseases, most typically endometriosis, uterine fibroids, uterine adenomyosis, or chronic pelvic inflammatory disease. The prevalence of dysmenorrhea is estimated to be between 45 and 95% among reproductive-aged women. Although not life threatening, dysmenorrhea can be debilitating and psychologically taxing for many women and is one of the leading causes of absenteeism from work and school.
Types of  Dysmenorrhea

Although most women have some discomfort with their periods, sometimes the pain is severe and may be accompanied by other symptoms (see box). This is called dysmenorrhea. There are two types of dysmenorrhea—primary or secondary.

Primary Dysmenorrhea

Primary dysmenorrhea is pelvic pain that comes from having your period and the natural production of prostaglandins. Often it begins soon after a pre-teen or teen starts having periods. In many cases, a woman’s periods become less painful as she gets older. The pain also may lessen after giving birth. However, some women continue to have pain during their periods.

Secondary Dysmenorrhea

Secondary dysmenorrhea has causes other than menstruation and the natural production of prostaglandins. It may begin later in life than primary dysmenorrhea. This type of pain often lasts longer than normal cramps. For instance, it may begin long before your period starts. The pain may get worse with your period and not go away after your period ends. Some of the most common causes of secondary dysmenorrhea are:

    Endometriosis—a condition in which tissue from the lining of the uterus is located outside of the uterus, such as in the ovaries and fallopian tubes. This tissue still acts like it does in the uterus. It responds to monthly changes in hormones and also breaks down and bleeds. This bleeding, which occurs outside of the uterus and vagina, can cause pain, especially right before, during, or after your period.
    Fibroids—muscle tumors or growths that form on the outside, the inside, or in the walls of the uterus. These tumors are not cancerous, but they can cause pain and heavy menstrual bleeding.
Dysmenorrhea may be classified as primary or secondary.

     primary dysmenorrhea – from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.

     secondary dysmenorrhea – due to some physical cause and usually of later onset; painful menstrual periods caused by another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).