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The Zoom In: What is Secondary Dysmenorrhea?

Looking into what secondary dysmenorrhea is and what causes it

4 min read | March 19, 2022

Secondary dysmenorrhea (dysmenorrhea being the scientific term for menstrual pain) refers to cramping in the lower abdomen that you may feel before or during a period, which occurs because there is a separate physical cause or reproductive disorder. ​​When it comes to severe menstrual cramps or painful periods, it can be confusing to determine whether they are primary dysmenorrhea or secondary dysmenorrhea symptoms. 

Secondary dysmenorrhea can be caused by medical conditions like: 

  • Endometriosis, which is when the tissue lining the uterus (endometrium) grows outside of the uterus, like on the ovaries, fallopian tubes, behind the uterus or on the bladder. This causes internal bleeding, infection or pelvic pain. 

  • Uterine fibroids, which are growths formed on the outside, inside or in the walls of the uterus.

  • Adenomyosis, a condition where the lining of the uterus grows into the muscle of the uterus, causing the uterus to become much bigger than it should be.

  • Pelvic inflammatory disease, an infection that starts in the uterus and can spread to other organs, usually caused by sexually-transmitted bacteria. 

If you’re not sure whether you’re experiencing primary or secondary dysmenorrhea, we’d suggest speaking to your health care provider. But a few indicators might be severe period pain – a burning or stabbing sensation that can last for many days and even remain between periods, that generally doesn’t subside - even with NSAIDs. 

Typical menstrual cramps or regularly painful periods to a certain extent are normal. Menstrual cramps and painful periods can simply be caused by uterine contraction from prostaglandins. You can also learn about how prostaglandins and menstrual cycle are related to better understand normal lower abdominal pain experienced before or during a period. These can be primary dysmenorrhea symptoms and can be confused for secondary dysmenorrhea symptoms as well. 

Typically, secondary pain happens later in life and can worsen over time, and needs treatment of the specific cause, although this can sometimes be hard to diagnose, thanks to the lack of research of reproductive disorders.

About Author

Your hormones can be complex and unpredictable. That’s why we’re here, on The Regular, to do what’s long overdue - to demystify what’s going on with our reproductive systems, our hormones and our whole cycle.

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