CHEARS

Menstruation is a part of the regular life cycle of a girl which plays a crucial role in reaching the milestones in their respective lives but few girls experience an abnormal condition which is an extremely painful condition and it is called Dysmenorrhea. It refers to the painful menstrual periods which are caused by uterine contractions. It is of two types in which the primary dysmenorrhea refers to recurrent pain, while secondary dysmenorrhea results from reproductive system disorders which both can be treated.

A recent study suggests that dysmenorrhea is a possible risk factor for chronic pain development among menstruating women and Some are not seeking for treatment.Although dysmenorrhea is highly prevalent among women, can cause significant disruptions in their daily lives, and may increase their risk for future chronic pain conditions. A better understanding of why women do not seek health care is necessary to develop strategies that facilitate care seeking and optimal symptom management.

Women aged 25–74 years at baseline when dysmenorrhea was measured in this and all of them were followed up for 10 years for the development of chronic pain. Furthermore, women with dysmenorrhea were more likely to experience chronic pain in more body regions.

Women with surgically visualized endometriosis reported the highest chronic/cyclic pain and significantly greater dyspareunia, dysmenorrhea, and dyschezia compared with women with other gynecologic pathology (including uterine fibroids, pelvic adhesions, benign ovarian cysts, neoplasms and congenital Müllerian anomalies) or a normal pelvis.

Women with a postoperative endometriosis diagnosis, compared with women diagnosed with other gynecologic disorders or a normal pelvis, reported more cyclic pelvic pain. Additionally, women with endometriosis compared with women with a normal pelvis experienced more chronic pain .Deep pain with intercourse, cramping with periods, and pain with bowel elimination were much more likely reported in women with versus without endometriosis . A higher percentage of women diagnosed with endometriosis compared with women with a normal pelvis reported vaginal, right labial  and left labial pain  along with pain in the right/left hypogastric and umbilical abdominopelvic regions . Among women with endometriosis, no clear and consistent patterns emerged regarding pain characteristics and endometriosis staging or anatomic location.

Endometrial shedding during the menstrual cycle elicits profound changes in neuronal activity and cytokines producing moderate to severe pelvic pain in more than 20% of reproductive-age women. One out of every five of those women in turn will develop chronic pelvic pain (CPP), yet women without dysmenorrhea rarely report CPP. CPP disorders such as irritable bowel syndrome (IBS) and painful bladder syndrome (PBS) can cause severe, unrelenting pain due to a lack of effective treatments.

Among women who had already undergone menopause at baseline, there was no evidence of an association between their history of dysmenorrhea and subsequent risk of chronic pain development.

The findings support the temporality of dysmenorrhea and chronic pain development. As such, early management of dysmenorrhea may benefit women and reduce the risk of and severity of chronic pain.

Dysmenorrhea may be a general risk factor for chronic pain, although whether primary dysmenorrhea increases the risk for chronic pain is unclear. Given that adolescence is a sensitive period for neurodevelopment, elucidating the role of primary dysmenorrhea in pain chronicity in future longitudinal studies is important for preventing both chronic pelvic and nonpelvic pain.

Assuming symptoms are normal, preferring to self‐manage symptoms, having limited resources, thinking providers would not offer help, being unaware of treatment options, considering symptoms to be tolerable, being wary of available treatments, feeling embarrassed or afraid to seek care and not seeking health care generally.

This can be irradicated by  these findings underscore the need to provide routine screening for dysmenorrhea, avoid dismissing dysmenorrhea symptoms, initiate discussions and provide education about dysmenorrhea, provide treatments options based on evidence and women's preferences and raise public awareness of dysmenorrhea and its impact.