Dysmenorrhea - American Family Physician

This clinical content conforms to AAFP criteria for evidence-based continuing medical education (EB CME). EB CME is clinical content presented with practice recommendations supported by evidence that has been systematically reviewed by an AAFP-approved source. P rimary dysmenorrhea, which is defined as painful menses in women with normal pelvic anatomy, usually begins during adolescence. It is characterized by crampy pelvic pain beginning shortly before or at the onset of menses and lasting one to three days. Dysmenorrhea also may be secondary to pelvic organ pathology. The prevalence of dysmenorrhea is highest in adolescent women, with estimates ranging from 20 to 90 percent, depending on the measurement method used.1-3 About 15 percent of adolescent girls report severe dysmenorrhea,1,4 and it is the leading cause of recurrent short-term school absenteeism in adolescent girls in the United States.2,5 A longitudinal study6 of a representative cohort of Swedish women found a prevalence of dysmenorrhea of 90 percent in women 19 years of age and 67 percent in women 24 years of age. Ten percent of the 24-year-olds reported pain that interfered with daily function. Most adolescents self-medicate with overthe-counter medicines, and few consult a physician about dysmenorrhea.1-3