Primary dysmenorrhoea

The prevalence of dysmenorrhoea is high. A Swedish study found that 72% of 19-year-old women reported dysmenorrhoea, nearly 40% regularly used medication for the pain and 8% stayed absent from work or school at every period [39]. According to an American study, 60% of menstruating young women suffered from dysmenorrhoea and 14% regularly missed school [40].

Primary dysmenorrhoea is associated with uterine hypercontractility characterized by excessive amplitude and frequency of contractions and a high 'resting' tone between contractions. During contractions endometrial blood flow is reduced and there seems to be a good correlation between minimal blood flow and maximal colicky pain, favouring the concept that ischaemia due to hypercontractility causes primary dysmenorrhoea. Prostaglandin and leukotriene levels are elevated in menstrual fluid and uterine tissue of women with dysmenor-rhoea as are systemic levels of vasopressin.

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