Let's recap: Dysmenorrhea is defined as pain associated with menstruation due to severe cramps. To read an overview about primary and secondary dysmenorrhea, check out our article on period pain here.
Now, let’s delve deeper into Secondary Dysmenorrhea. This kind of period pain is an indication of an underlying reproductive system disorder and typically lasts longer than normal menstrual cramps. The pain will start a few days before the menstrual cycle and continue to get worse as the cycle progresses.
Unlike with primary dysmenorrhea, secondary dysmenorrhea will often begin later in life and the associated pain tends to get worse over time.
The disorder that most commonly causes secondary dysmenorrhea is endometriosis. With endometriosis, the tissue which lines the uterus (endometrium) is found in areas outside of the uterus, such as the ovaries, fallopian tubes, and bladder. As our hormones fluctuate, these tissues begin to act as they would within the uterus and they break down and bleed. Not only can this bleeding cause a great deal of pain on its own, it also promotes the growth of scar tissue (adhesions) which can cause organs to painfully stick together.
Other causes of secondary dysmenorrhea include:
- Adenomyosis: a condition in which uterine lining begins to grow in the muscle of the uterus
- Uterine Fibroids: benign tumors that can form on the inside, outside, or the walls of the uterus
- Pelvic Inflammatory Disease: an infection caused by bacteria in the uterus that spreads to other surrounding reproductive organs
If you are experiencing dysmenorrhea, be sure to see your provider so that they can rule out any other potential causes and give you a definitive diagnosis. Your provider will likely ask your overall health history as well as your menstrual history. They will also typically perform a physical exam and a pelvic exam and possibly an ultrasound, MRI and laparoscopy.