Secondary dysmenorrhea may be caused by gynecological diseases

Dysmenorrhea is a common phenomenon among women. It brings great trouble to women’s daily work and life. Dysmenorrhea can be divided into primary dysmenorrhea and secondary dysmenorrhea. There are many reasons for secondary dysmenorrhea. What are the specific factors?

1. Uterine fibroids

Dysmenorrhea is not the main symptom of uterine fibroids, but submucosal fibroids can cause spasmodic pain during menstruation due to stimulation of uterine contractions. Patients often have menorrhagia, prolonged menstruation or irregular vaginal bleeding. Pelvic examination may reveal varying degrees of enlargement of the uterus, with a smooth surface or nodular protrusions.

2. Intrauterine device

Dysmenorrhea can also be seen in women who have an intrauterine contraceptive device. This type of dysmenorrhea may be caused by an increase in prostaglandins produced by the endometrium, or it may be that the contraceptive device stimulates the rejection contraction of the uterine muscles, leading to spasmodic pain in the lower abdomen. Patients often have discomfort in the lower abdomen or lumbar region, and their menstrual symptoms worsen, manifesting as dysmenorrhea. Improper placement of the IUD or an oversized IUD can also easily cause uterine contractions, leading to lower abdominal pain and dysmenorrhea.

3. Chronic pelvic inflammatory disease

Lower abdominal pain and infertility are the main symptoms of chronic pelvic inflammatory disease. During menstruation, pelvic congestion or acute inflammation induced by menstruation can cause abdominal pain to worsen. Most patients have a history of infertility and acute pelvic inflammatory disease. Pelvic examination shows that the uterus is often posterior, with poor mobility or even completely fixed.

4. Reproductive tract malformations

During embryonic development, one side of the mesonephric duct can develop well, forming a well-developed unicornuate uterus. The paramesonephric duct on the other side is poorly developed, forming a rudimentary horn or a primordial uterus, which is not connected to the opposite side or to the body. The primordial uterus generally has no uterine cavity, or if there is a uterine cavity, it lacks endometrium. If the primordial uterus has functional response, manifested as periodic bleeding, dysmenorrhea may be caused by blood accumulation in the uterine cavity. Most of the patients are young girls.

5. Adenomyosis

Dysmenorrhea is a benign disease caused by the invasion of the endometrium into the myometrium, and is one of the typical symptoms of this disease. There may also be increased menstrual flow or prolonged menstrual period. Gynecological examination shows that the uterus is uniformly enlarged and spherical, with a hard texture. It is generally about the size of a 2-month gestation and may be slightly tender.

6. Pelvic Endometriosis

Dysmenorrhea is the main symptom of endometriosis. The ectopic endometrial tissue in the ovaries, uterine cuboid ligaments, uterorectal fossa and pelvic peritoneum is also affected by ovarian hormones during the menstrual cycle and undergoes cyclical changes.

7. Pelvic venous congestion syndrome

This disease is a female internal reproductive organ disease caused by chronic pelvic venous congestion. The main clinical manifestations include pelvic distension, lower abdominal and lumbar pain, and are often accompanied by excessive menstruation, increased leucorrhea and dysmenorrhea. Symptoms often worsen when tired, sitting or standing for a long time during sexual intercourse, or when constipated. Some patients also have breast tenderness and bladder and rectal irritation symptoms.