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Secondary Dysmenorrhea
Aka: Secondary Dysmenorrhea, Congestive Dysmenorrhea
- See Also
- Dysmenorrhea
- Primary Dysmenorrhea
- Acute Pelvic Pain
- Chronic Pelvic Pain
- Definitions
- Secondary Dysmenorrhea
- Painful Menses secondary to underlying pelvic organic disorder
- Epidemiology
- Accounts for 10% of Dysmenorrhea cases
- 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)
- Symptoms
- See Dysmenorrhea
- Variable or worsening Chronic Pelvic Pain
- Abnormal Uterine Bleeding
- Vaginal Discharge
- Dyspareunia
- Evaluation
- See Dysmenorrhea
- Causes: Secondary Dysmenorrhea (pelvic pathology)
- See Dysmenorrhea
- See Chronic Pelvic Pain
- Emergent causes
- Ectopic Pregnancy
- 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
- 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
- Miscellaneous causes
- See Chronic Pelvic Pain in Women
- Intrauterine Device (IUD)
- Ovarian Cysts (transient Ovarian Torsion, ruptured Ovarian Cyst)
- Cervical stenosis
- Amenorrhea
- Infertility
- 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
- Amenorrhea
- Infertility
- Miscarriages
- Pelvic Mass
- Nausea
- Bloating
- Frequent Urination
- Differential Diagnosis
- See Primary Dysmenorrhea
- See Chronic Pelvic Pain
- Management
- See Dysmenorrhea for evaluation and management
- Evaluate and treat the underlying cause
- Symptomatic treatment as with Primary Dysmenorrhea
- References
- McKenna (2021) Am Fam Physician 104(2): 164-70 [PubMed]