Primary dysmenorrhea is an often underestimated condition that is characterized by pain in the lower abdomen and is observed shortly before or at the onset of menstruation. Dysmenorrhea can have a negative impact on the quality of life and productivity in the daily life of affected patients. Increased prostaglandin production is thought to be the cause of the pelvic pain that is characteristic of the condition. Associated symptoms can be both physical and mental in nature. Among them, the most common are: Headache; Lethargy; Sleep disorders; Tension and pain in the chest; Drowsiness; Back pain; Pain in the knees and the inner part of the lower limbs; Muscle pain; Swelling of the limbs; Joint pains; Swelling; Pains in different parts of the body; Changes in appetite; Nausea; Vomiting; Constipation; Diarrhea; Increased urination; Changes in mood; Anxiety; Depression; Irritability. Dysmenorrhea is characteristic of adolescence, within 6-24 months after the onset of the first menstruation. The pain is usually characterized by a cyclical nature, is usually acute during the first days of menstruation and lasts for 72 hours. Secondary dysmenorrhea, on the other hand, is due to the presence of pathological processes. These can be endometriosis, chronic pelvic inflammatory disease, adenomyosis, endometrial polyps, ovarian cysts and complications that can occur when using intrauterine contraceptives. Diffuse and constant pain is observed with it, which is not always observed exclusively and only during menstruation. Among them, the most common cause of dysmenorrhea is endometriosis. It is suggested that a key element of the pathogenesis of dysmenorrhea is the synthesis of prostaglandins in the uterus during the characteristic changes that occur in the endometrium within each menstrual cycle. They are important for stimulating contractions of the uterine muscles and reducing the lumen of blood vessels – vasoconstriction. This leads to a lack of oxygen in the uterus and the production of anaerobic metabolites. In this way, the sensitivity of the nerve fibers that are responsible for pain sensations increases and this is the cause of pelvic pain. Prostaglandins are synthesized by a cascade involving the arachidonic acid and cyclooxygenase pathways. Arachidonic acid synthesis is regulated by progesterone levels and by the activity of the lysosomal enzyme phospholipase. Progesterone levels peak in the middle of the luteal phase, which occurs after ovulation. If fertilization does not occur, degeneration of the corpus luteum and a decrease in serum progesterone concentrations are observed. This rapid drop in progesterone levels leads to changes in the endometrium, onset of menstruation and release of lysosomal enzymes. They, on their part, ensure the production of alachidonic acid, from which prostaglandins are obtained.In women with regular menstruation, high levels of prostaglandins are observed in the endometrium during the late luteal phase. Studies have shown that patients with dysmenorrhea have higher levels of prostaglandins. Therefore, muscle cramps, as well as the strength of the pain sensation and related symptoms, are determined by the higher levels of prostaglandins in the endometrium. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943241/#:~:text=Dysmenorrhea is defined as painful, of childbearing age [1].