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  • Dysmenorrhoea means pain during menstruation.
  • About 60 to 70% of adolescent female have dysmenorrhoea. Most of them have mild symptoms. However, about 25% of them have severe dysmenorrhoea that interferes with their daily activities.
  • Dysmenorrhoea can be classified into primary or secondary dysmenorrhoea
  • Secondary dysmenorrhoea occurs mostly in adult female in which the pain is associated with an existing condition such as pelvic inflammatory disease (PID) and endometriosis.
  • Primary dysmenorrhoea usually occurs in teenagers and usually not associated with any existing medical illness.
  • Primary dysmenorrhoea usually occurs 2 to 3 years after menarche (first menstrual flow) and can get worst at the ages between 15 to 25 years old.
  • Primary dysmenorrhoea usually becomes less painful as a woman ages and may stop entirely if the woman has a baby.
  • Dysmenorrhoea occurs when chemical called prostaglandin is released during menstruation causing the uterus to contract and constricting the blood supply to the endometrial tissue.
    • Prostaglandin is produced by the destruction of the endometrial cells (inner layer of the uterus) due to the raised progestrone level during ovulation.


  • Symptoms usually occur within 24 hours before menstruation and can last up to 1 to 3 days during menstruation.
  • The pain is usually in the lower abdomen and can radiate to the back and thigh.
  • Other symptoms include vomiting and diarrhoea.

Diagnosis and treatment

  • A diagnosis of primary diarrhoea is made when no underlying illness is causing the pain.
  • Primary dysmenorrhoea is treatable with oral contraceptive pill (OCP) and NSAIDS (Non-Steroidal Anti Inflammatory Drugs) such as mefenemic acid (ponstan), ibuprofen and diclofenac sodium (voltaren)
  • OCP can stop ovulation and prevent the progestrone hormone to increase. This , in turn can reduce the production of prostaglandin.
  • NSAIDS acts by reducing the production of prostaglandin

Self – care tips

  • Take NSAIDS immediately when you feel the first signs of dysmenoorhoea and to continue taking it regularly, up to day 5 of menstruation (according to your doctor’s prescription)
Last Reviewed : 28 August 2020
Writer : Dr. Salmiah bt. Md. Sharif
Reviewer : Dr. Nazhatussima bt. Suhaili