Primary dysmenorrhea

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Clinical Presentation and Diagnosis:

Primary dysmenorrhea usually presents during adolescence, within three years of menarche.

It is unusual for symptoms to start within the first six months after menarche. Affected women experience sharp, intermittent spasms of pain, usually centered in the suprapubic area. Pain may radiate to the back of the legs or the

lower back. Systemic symptoms of nausea, vomiting, diarrhea, fatigue, fever, headache or lightheadedness are fairly common. Pain usually develops within hours of the start

of menstruation and peaks as the flow becomes heaviest during the first day or two of the cycle.

A focused history and physical examination are usually sufficient to make the diagnosis of primary dysmenorrhea. The history reveals the typical cramping pain with menstruation, and the physical examination is completely normal. Secondary causes of dysmenorrhea must be excluded .

Unusual within first six months of menarche Intermittent spasms of pain with systemic symptoms coinciding with onset of menses

Secondary dysmenorrhea must be excluded

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I used to have very painful periods. After I had my baby they haven't hurt at all.

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