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Review
. 2023 Apr 3:15:499-509.
doi: 10.2147/IJWH.S380006. eCollection 2023.

Disease Burden of Dysmenorrhea: Impact on Life Course Potential

Brittany MacGregor  1 , Catherine Allaire  1 , Mohamed A Bedaiwy  1 , Paul J Yong #  1 , Olga Bougie #  2
Affiliations
Review

Disease Burden of Dysmenorrhea: Impact on Life Course Potential

Brittany MacGregor et al. Int J Womens Health. .

Abstract

Dysmenorrhea is the most common gynecologic condition among the female population and has a significant impact on life course potential. It has a widespread impact on a female's mental and physical well-being, with longstanding impairments on quality of life, personal relationships, and education and career attainment. Furthermore, untreated dysmenorrhea can lead to hyperalgesic priming, which predisposes to chronic pelvic pain. Primary dysmenorrhea is pain in the lower abdomen that occurs before or during menses and in the absence of pelvic pathology. One possible mechanism is endometrial inflammation and increased prostaglandin release, resulting in painful uterine contractions. Dysmenorrhea may also occur secondary to pelvic pathology, such as endometriosis, adenomyosis or due to cyclic exacerbation of non-gynecologic pain conditions. A thorough patient evaluation is essential to differentiate between potential causes and guide management. Treatment must be tailored to individual patient symptoms. Pharmacologic management with non-steroidal anti-inflammatory medications and/or combined hormonal contraceptives is most common. Heat therapy, exercise, vitamins and dietary supplements have limited evidence and can be offered for patients seeking non-pharmacologic adjunctive or alternative options. Greater awareness for both health-care providers and patients allows for early intervention to reduce impact on quality of life and life course potential.

Keywords: adolescents; chronic pain; health trajectory; primary dysmenorrhea; women’s health.

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Conflict of interest statement

Dr. Catherine Allaire reports personal fees from Abbvie, personal fees from Ferring, outside the submitted work. Dr. Mohamed Bedaiwy reports financial affiliations with Ferring Pharmaceuticals, AbbVie, and Baxter. Dr Paul J Yong is supported by a Health Professional Investigator Award from Michael Smith Health BC and a Canada Research Chair (Tier 2) in Endometriosis and Pelvic Pain. Dr. Olga Bougie reports financial affiliations with Hologic and AbbVie. Received Grant from SRI-Bayer. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Pathophysiology of primary dysmenorrhea. Endometrial inflammation from progesterone drop in ovulatory cycles can lead directly to dysmenorrhea, although recent studies suggest dysmenorrhea can also occur in anovulatory cycles. Inflammation may provoke myometrial contractions that contribute to dysmenorrhea and further compound inflammation. Through hyperalgesic priming, recurrent dysmenorrhea may cause central nervous system changes that themselves amplify dysmenorrhea and also predispose to chronic pain. There may be a genetic predisposition at each of these steps.
Figure 2
Figure 2
Impact of dysmenorrhea. This figure demonstrates possible impairments of dysmenorrhea and the impact on life course potential.
See this image and copyright information in PMC

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