• Gabriele Tridenti
  • Cristina Vezzani


Affecting up to 85% women, dysmenorrhea is the most frequent genital complaint in teenage and the main cause of school absenteeism, with important social relapses. Primary dysmenorrhea, namely, without underlying pelvic pathologies, occurs in 90% cases. Typically, it shows lower abdominal pains, requiring medications or limiting normal activities, starting with the onset of menses, strictly connected to ovulatory cycles and lasting no more than 2–3 days. It is due to the activation of prostaglandins (PGs) and leukotrienes (LTs) cascade in the uterine wall. Associated symptoms are frequent. Secondary dysmenorrhea, occurring in the remaining 10% cases, is later-onset and associated with well-defined pelvic pathologies, mainly endometriosis and obstructive genital anomalies. Diagnosis of primary dysmenorrhea is mostly clinical and ultrasonography may be useful to detect or to rule out secondary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) are first choice to be administered at full dose at the very onset of menstrual flow for no more than 2–3 days long. Oral contraceptives (OCs) are advisable after an unsuccessful 6 months treatment with NSAIDs. If OCs are also unsuccessful, diagnostic and operative laparoscopy is recommended to detect and treat secondary dysmenorrhea, mostly endometriosis and/or obstructive Mullerian anomalies. Non-medical options and complementary and alternative medicine are also discussed.


Adolescence Dysmenorrhea Guideline Teenage Treatment 



American College of Obstetricians and Gynecologists


Erythrocyte sedimentation rate


Food and Drug Administration




Istituto di Ricovero e Cura a Carattere Scientifico




Non-steroidal anti-inflammatory drug


Oral contraceptive


Obstructed hemi vagina ipsilateral renal agenesis


Prostaglandin E2


Prostaglandin F




Pelvic inflammatory disease


Sexually transmitted disease


Transcutaneous electric nerve stimulation


Visual Analogue Score


Verbal Multidimensional Scoring System


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologySanta Maria Nuova Hospital—IRCCSReggio EmiliaItaly

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