24. PRIMARY DYSMENORRHEA
• Painful menstruation with no pelvic pathology
• Usually starts 2-3 yrs after menarche and
ceases after child birth.
• Begins shortly before or at the onset of
menses and lasts one or three days
Pain is due to pelvic congestion which is
more marked in the premenstrual period.
Pain increases in its severity as menstruation
approaches and is relieved by the onset of
menstrual flow, due to the diminution of
Treat the cause rather than symptom
Diagnostic hysteroscopy followed by D&C
Laprotomy followed by excision of
Hysterectomy in elderly