Menstruation occurring with severe pain, which leads to disruption of a woman’s lifestyle, is referred to as dysmenorrhea. It is the most common gynecological diagnosis among women who have reached puberty. The percentage of women who seek medical help with complaints that characterize dysmenorrhea is about 45-50%. Most common complaints associated with dysmenorrhea Pain is a major complaint associated with dysmenorrhea. Women most often report pain in the lower abdomen, but it can also be felt on the inner thighs or lower back. The feeling of pain is associated with the onset of menstruation and can last from a few hours to 48-72 hours. Nausea and vomiting are common complaints that accompany women with dysmenorrhea in the first days. Apart from them, women may also have other complaints such as diarrhea or constipation. Very often, dysmenorrhea is also associated with heavy menstruation, the duration of which may be longer than 5-7 days. Some women complain of severe and prolonged headaches during this period or of feeling tired. Reasons for the appearance of painful menstruation The appearance of monthly menstrual bleeding is related to the shedding of the surface layer of the uterine mucosa – the functional layer. During the previous days of the month, this layer developed and prepared to receive the fertilized egg and for the development of a possible pregnancy. In the absence of fertilization of the ovum, the separation of the mucous membrane occurs gradually like the rupture and is supported by shortening of the uterine muscle layer – contractions. They are one of the causes of pain and discomfort during this period. Studies have been done in women with dysmenorrhea, according to which the levels of prostaglandins – these are locally acting molecules – are increased. As a result of their function, uterine contractions are strengthened and vasoconstriction occurs – narrowing of blood vessels. Their increased levels in some women are the cause of increased pain and discomfort during menstruation. NEWS_MORE_BOX Types of dysmenorrhea Dysmenorrhea can be divided into two types, depending on the reasons associated with the occurrence of pain during the menstrual cycle. 1. Primary dysmenorrhea – there are no disorders in the female reproductive system. This type of dysmenorrhoea occurs in young women in whom the first menstruation – menarche – has occurred earlier. A woman’s psycho-emotional state can also have an impact on complaints and their perception. 2. Secondary dysmenorrhoea – in this type, most often the complaints are due to the presence of a disease that affects the genitals. Most often, this type appears several years after the first menstruation. Reasons that can lead to the appearance of pain are the presence of endometriosis, pelvic inflammatory disease, formations of the ovaries or the uterus – myoma. Treatment of the condition dysmenorrhea Women,in which the complaints are very pronounced and this leads to the impossibility of fulfilling their daily duties, medication can be administered to achieve symptom relief. Most often, nonsteroidal anti-inflammatory drugs are administered a few days before menstruation and during the first days of the cycle. Hormonal preparations may also help to reduce complaints. For women with a heavy menstrual period, rest is recommended during the first days of menstruation.