II. Definitions
- Secondary Dysmenorrhea
- Painful Menses secondary to underlying pelvic organic disorder
III. Epidemiology
- Accounts for 10% of Dysmenorrhea cases
IV. History: Findings suggestive of Secondary Dysmenorrhea
- Changed Dysmenorrhea character, location or intensity
- History of prior Sexually Transmitted Disease
- Prior abdominal or pelvic surgery
- Pelvic Pain persisting throughout cycle
- Infertility
- Abnormal Menstrual Bleeding
- Endometriosis type Rectal Pain or Dyspareunia
- Family History of Endometriosis (in a first degree relative)
V. Symptoms
- See Dysmenorrhea
- Variable or worsening Chronic Pelvic Pain
- Abnormal Uterine Bleeding
- Vaginal Discharge
- Dyspareunia
VI. Evaluation
- See Dysmenorrhea
VII. Causes: Secondary Dysmenorrhea (pelvic pathology)
- See Dysmenorrhea
- See Chronic Pelvic Pain
- Emergent causes
- Most common causes
- Endometriosis (most common)
- Pelvic Pain variable in timing and intensity
- Dyspareunia
- Infertility
- Pain with urination and Bowel Movements
- Pelvic Inflammatory Disease (PID)
- Abdominal Pain, fever and foul Vaginal Discharge
- Dyspareunia
- Sexually Transmitted Infection
- Post-coital bleeding
- Endometriosis (most common)
- Other Common causes
- Uterine Myomata (Uterine Fibroids)
- More common at older age
- Menorrhagia, with prolonged menstrual periods
- Constipation
- Urinary Outflow Obstruction
- Adenomyosis (Endometriosis of Uterus)
- More common at older age
- Menorrhagia, passing blood clots
- Dyspareunia
- Interstitial Cystitis
- Non-cyclical Suprapubic Pain with urinary tract symptoms
- Chronic Pelvic Pain
- Non-cyclical Pelvic Pain
- Uterine Myomata (Uterine Fibroids)
- Miscellaneous causes
- See Chronic Pelvic Pain in Women
- Intrauterine Device (IUD)
- Ovarian Cysts (transient Ovarian Torsion, ruptured Ovarian Cyst)
- Cervical stenosis
- Postsurgical pelvic adhesions
- Prior abdominal or genitourinary surgery
- Infertility
- Small Bowel Obstruction
- Worse with movement
- Painful Defecation
- Endometrial Polyps
- Irregular Vaginal Bleeding
- Congenital obstructive mulleian malformation
- Pelvic Mass
- Nausea
- Bloating
- Frequent Urination
VIII. Differential Diagnosis
IX. Management
- See Dysmenorrhea for evaluation and management
- Evaluate and treat the underlying cause
- Symptomatic treatment as with Primary Dysmenorrhea
X. References
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Related Studies
| Concepts | Pathologic Function (T046) |
| ICD10 | N94.5 |
| SnomedCT | 156025005, 198406004, 266667002, 32096006 |
| Spanish | dismenorrea secundaria (trastorno), Dismenorrea secundaria, dismenorrea secundaria (hallazgo), dismenorrea secundaria |
| Dutch | secundaire dysmenorroe, congestie; dysmenorroe, dysmenorroe; congestief, dysmenorroe; secundair, secundair; dysmenorroe, Secundaire dysmenorroe |
| French | Dysménorrhée secondaire |
| German | sekundaere Dysmenorrhoe, Sekundaere Dysmenorrhoe |
| Italian | Dismenorrea secondaria |
| Portuguese | Dismenorreia secundária |
| Japanese | 続発性月経困難症, ｿﾞｸﾊﾂｾｲｹﾞｯｹｲｺﾝﾅﾝｼｮｳ |
| Czech | Sekundární dysmenorea |
| Korean | 속발성 월경통 |
| English | secondary dysmenorrhoea, secondary dysmenorrhea (diagnosis), secondary dysmenorrhea, dysmenorrhea secondary, Secondary dysmenorrhoea (disorder), Secondary dysmenorrhea, Congestive dysmenorrhea, Congestive dysmenorrhoea, Secondary dysmenorrhoea, Secondary dysmenorrhea (disorder), congestive; dysmenorrhea, dysmenorrhea; congestive, dysmenorrhea; secondary, secondary; dysmenorrhea, Secondary dysmenorrhea (finding) |
| Hungarian | másodlagos dysmenorrhea, másodlagos dysmenorrhoea |
