What Causes Secondary Dysmenorrhea

Secondary Dysmenorrhea is a condition that causes severe menstrual cramps and pelvic pain. Still, unlike primary Dysmenorrhea, it is typically associated with an underlying medical issue. In this article, we will explore the symptoms, causes, diagnosis, and treatment options for secondary Dysmenorrhea. From endometriosis to ovarian cysts, we will discuss the various conditions that can lead to this painful menstrual disorder. Stay tuned to learn more about how secondary Dysmenorrhea can be managed and whether it can be prevented.

What is Secondary Dysmenorrhea?

Secondary Dysmenorrhea is a condition characterized by painful menstrual cramps caused by an underlying pelvic pathology affecting the reproductive organs.

This type of Dysmenorrhea differs from primary Dysmenorrhea, as it is not a normal part of the menstrual cycle but rather a symptom of an underlying issue. Symptoms of secondary Dysmenorrhea may include severe pelvic pain, lower back pain, abnormal menstrual bleeding, and digestive issues.

Common causes of secondary Dysmenorrhea can be linked to conditions such as endometriosis, fibroids, pelvic inflammatory disease, or Adenomyosis. Diagnosis usually involves a thorough medical history, physical examination, pelvic ultrasound, or sometimes, more invasive procedures like laparoscopy to identify the root cause of the pain.

What are the Symptoms of Secondary Dysmenorrhea?

The Symptoms of Secondary Dysmenorrhea include severe menstrual painabnormal bleeding, and chronic pelvic discomfort that significantly impact a person’s quality of life.

Secondary Dysmenorrhea is often distinguished from primary Dysmenorrhea by its association with conditions such as endometriosis, fibroids, or pelvic inflammatory disease.

Aside from the intense period pain, individuals with secondary Dysmenorrhea may experience additional symptoms like lower back pain, pain during intercourse, and digestive issues.

Irregular menstrual cycles, heavy menstrual flow, and spotting between periods are common indicators of secondary Dysmenorrhea, requiring thorough medical evaluation for proper diagnosis and management.

How is it Different from Primary Dysmenorrhea?

Secondary Dysmenorrhea differs from Primary Dysmenorrhea in that it is typically caused by an underlying gynecological condition such as endometriosis, fibroids, or pelvic inflammatory disease instead of normal uterine contractions.

These conditions lead to more severe and debilitating menstrual pain compared to primary Dysmenorrhea. Women with secondary Dysmenorrhea may experience additional symptoms like abnormal bleeding, unusual vaginal discharge, and pain during intercourse.

Diagnosis of secondary Dysmenorrhea often involves a thorough medical history, pelvic examination, imaging tests such as ultrasound or MRI, and sometimes laparoscopy. Treatment approaches for secondary dysmenorrhea focus on managing the underlying cause, which can include medications, hormonal therapy, or surgery, depending on the specific condition.

What Causes Secondary Dysmenorrhea?

What is Secondary Dysmenorrhea - What Causes Secondary Dysmenorrhea

Secondary Dysmenorrhea can be caused by various factors, including

  • Endometriosis

Endometriosis is a gynecological condition where tissue similar to the lining of the uterus grows outside the uterus, often leading to severe pelvic pain and menstrual irregularities.

This condition affects millions of individuals worldwide, causing various symptoms such as painful periods, infertility, fatigue, and gastrointestinal issues. The abnormal growth of endometrial-like tissue can create scar tissue, adhesions, and inflammation in the pelvic region, leading to debilitating discomfort.

  • Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs often caused by sexually transmitted bacteria, leading to abdominal pain, abnormal vaginal discharge, and menstrual irregularities.

PID typically occurs when bacteria from the vagina or cervix travel up into the uterus, fallopian tubes, or ovaries. Common causes include untreated sexually transmitted infections like chlamydia and gonorrhea.

Symptoms of PID can vary, ranging from mild discomfort to severe pelvic pain. In some cases, it may even lead to complications like infertility or ectopic pregnancy. Diagnosis of PID often involves a physical examination, lab tests, and imaging studies such as ultrasounds or MRIs. Treatment usually includes antibiotics to clear the infection and prevent further complications.

  • Uterine Fibroids

Uterine Fibroids are noncancerous growths in the uterus that can cause heavy menstrual bleeding, pelvic pressure, and pain, affecting a person’s overall well-being and reproductive health.

These fibroids vary in size, ranging from small seedlings to large bulky masses, and can be present in different locations within the uterus. Some individuals may experience increased cramping during menstruation, prolonged periods, frequent urination, and even constipation due to the pressure exerted by these growths on surrounding organs.

In terms of treatment, options range from conservative management with medications to surgical interventions such as myomectomy and hysterectomy, depending on the severity of symptoms and the desire for future fertility.

  • Adenomyosis

Adenomyosis is a condition where the inner lining of the uterus breaks through the muscle wall, leading to heavy periods, severe cramps, and chronic pelvic pain that can significantly disrupt daily activities.

This gynecological disorder primarily affects women in their childbearing years and is characterized by symptoms such as prolonged and heavy menstrual bleeding, as well as pain during intercourse. The exact cause of Adenomyosis is not definitively known, but hormonal imbalances and inflammation are believed to play a role in its development. Diagnosis often involves a combination of clinical evaluation, imaging tests such as ultrasound or MRI, and sometimes a biopsy to confirm the presence of adenomyotic tissue.

  • Cervical Stenosis

Cervical Stenosis is a narrowing of the cervix that can impede menstrual flow, leading to severe cramping, pelvic pain, and menstrual irregularities, requiring medical intervention for symptom relief.

Due to the narrowing of the cervix, women with cervical stenosis may experience heavier menstrual flow due to the restriction in the passage of blood. This can result in increased pressure in the pelvic region, leading to discomfort and pain.

  • Intrauterine Device (IUD)

Secondary dysmenorrhea, often triggered by the presence of an IUD, presents symptoms similar to primary dysmenorrhea but is influenced by the contraceptive device. The potential side effects of IUDs, including increased menstrual cramps, heavier bleeding, and irregular periods, can contribute to the development of secondary dysmenorrhea. Management strategies for this condition may involve pain relief medication, hormonal treatments, or removal of the IUD based on the severity of symptoms.

It is crucial for individuals experiencing persistent or severe pain after IUD insertion to seek medical assessment promptly to rule out any underlying issues causing secondary dysmenorrhea. Regular check-ups with healthcare providers can help monitor the impact of the IUD on menstrual health and adjust the contraceptive method if necessary.

  • Ovarian Cysts

Ovarian Cysts are fluid-filled sacs that can form on the ovaries, leading to pelvic discomfort, irregular periods, and potential complications if left untreated, necessitating medical evaluation and appropriate management.

These cysts often develop as a normal part of the menstrual cycle, with most resolving on their own without intervention. However, complex ovarian cysts may require closer monitoring or treatment as they can cause serious symptoms such as persistent pain, bloating, or changes in bowel habits. In some cases, ovarian cysts can affect fertility or lead to ovarian torsion, a medical emergency where the cyst causes the ovary to twist, cutting off its blood supply.

  • Polyps

Polyps are abnormal tissue growths that can develop in the uterus or cervix, causing irregular bleeding, pelvic pain, and other menstrual disturbances that require medical attention for diagnosis and appropriate management.

These growths are usually benign but can sometimes be associated with more serious conditions, such as cancer. Symptoms of polyps may include heavy or prolonged menstrual bleeding, bleeding between periods, and pain during intercourse.

To diagnose uterine or cervical polyps, gynecologists may perform a pelvic exam, ultrasound, or hysteroscopy. Treatment options range from medication to remove the polyps non-invasively to surgical procedures for larger or symptomatic growths.

It is essential to seek medical advice if you experience any of these symptoms to ensure timely and effective management of polyps.

  • Use of Certain Medications

Certain medications, such as anticoagulants or hormonal therapies, may contribute to the development of Secondary Dysmenorrhea, impacting menstrual cycles, pain perception, and overall gynecological health.

Anticoagulants like aspirin or heparin can disrupt the normal clotting process of the uterine lining, exacerbating menstrual cramps and causing heavier bleeding in individuals with Secondary Dysmenorrhea. This prolonged and increased blood flow can lead to more intense pelvic pain during menstruation. Hormonal therapies, including birth control pills, can affect the balance of estrogen and progesterone, influencing the severity of menstrual symptoms.

Pain management becomes challenging as these medications alter the natural hormonal fluctuations within the body, impacting the overall gynecological well-being of the individual.

  • Chronic Pelvic Pain

Chronic Pelvic Pain is a complex condition that can be associated with Secondary Dysmenorrhea, involving persistent discomfort in the pelvic region that may require a multidisciplinary approach for diagnosis and management.

Diagnosing Chronic Pelvic Pain and Secondary Dysmenorrhea can pose challenges due to overlapping symptoms and underlying conditions that may contribute to the pain perception.

In terms of treatment, a tailored approach focusing on pain management, hormonal regulation, and addressing potential underlying causes such as endometriosis or fibroids is crucial for long-term relief.

A comprehensive care plan for individuals experiencing these conditions should involve close collaboration between gynecologists, pain specialists, and mental health

How is Secondary Dysmenorrhea Diagnosed?

Diagnosing Secondary Dysmenorrhea involves a thorough medical history review, physical examination, imaging studies, and, in some cases, minimally invasive procedures to identify the underlying cause of pelvic pain and menstrual disturbances.

In the diagnostic process for Secondary Dysmenorrhea, the initial step typically includes taking a detailed medical history to understand the patient’s symptoms, menstrual patterns, and past medical conditions that could be contributing to the pain. This is followed by a comprehensive physical examination focusing on pelvic tenderness, masses, or abnormalities. Imaging techniques such as transvaginal ultrasound or MRI may be utilized to visualize the reproductive organs and detect any structural abnormalities. In cases where further clarity is needed, invasive procedures like laparoscopy may be recommended to directly visualize the pelvic area and obtain biopsies if necessary.

What are the Treatment Options for Secondary Dysmenorrhea?

Treatment options for Secondary Dysmenorrhea may include addressing the underlying cause, pain medications, hormonal birth control, and, in some cases, surgical interventions to alleviate pelvic pain and improve menstrual symptom management.

Addressing the underlying cause of Secondary Dysmenorrhea is essential for long-term relief. Depending on the specific issue, treatments may focus on reducing inflammation, managing endometriosis, or correcting structural abnormalities.

Pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can effectively reduce pain and discomfort during menstruation. They work by decreasing prostaglandin levels responsible for uterine contractions and inflammation.

Hormonal birth control methods, like oral contraceptives or intrauterine devices (IUDs), help regulate menstrual cycles and reduce the severity of symptoms by stabilizing hormonal fluctuations.

In cases where conservative treatments are ineffective, surgical interventions like laparoscopy may be recommended to diagnose and treat conditions such as endometriosis or fibroids, providing lasting pain relief and improved reproductive health.

Addressing the Underlying Cause

Addressing the Underlying Cause of Secondary Dysmenorrhea is crucial in developing an effective treatment plan that targets the specific pelvic pathology contributing to the menstrual pain and discomfort.

By identifying the root cause of Secondary Dysmenorrhea, healthcare providers can tailor treatments to address the underlying conditions rather than just alleviating the symptoms. This approach helps manage pain more effectively and promotes long-term gynecological health. Understanding the underlying pathology, such as endometriosis or fibroids, allows for targeted interventions that can improve quality of life and reduce the need for frequent medication use.

Pain Medications

Pain Medications such as NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are commonly used to alleviate menstrual cramps and pelvic discomfort in individuals with Secondary Dysmenorrhea, providing effective pain relief during menstruation.

NSAIDs work by reducing the production of prostaglandins, which are responsible for causing inflammation and pain in the body. By targeting this specific mechanism, NSAIDs help in managing the pain associated with Secondary Dysmenorrhea. The typical dosage of NSAIDs for menstrual pain relief is usually recommended to be taken every 4-6 hours as needed, with the maximum daily dose not exceeding a certain limit to avoid potential side effects.

  • The effectiveness of NSAIDs in managing pain associated with Secondary Dysmenorrhea varies from person to person, with some individuals experiencing significant relief. In contrast, others may require additional pain management strategies.
  • Individuals need to be cautious of potential side effects of NSAIDs, such as gastrointestinal issues, kidney problems, and an increased risk of bleeding, especially if taken in high doses or for prolonged periods.

Hormonal Birth Control

Hormonal Birth Control methods, such as Hormonal Contraceptives, can help regulate menstrual cycles, reduce pain, and improve overall gynecological health in individuals with Secondary Dysmenorrhea.

One of the main benefits of using Hormonal Birth Control in managing Secondary Dysmenorrhea is the ability to lessen the severity of menstrual cramps by inhibiting prostaglandin production. By suppressing ovulation, hormonal contraceptives also help reduce the amount of blood and tissue that is expelled during menstruation, which can alleviate heavy bleeding associated with Dysmenorrhea.

These contraceptives can regulate menstrual cycles, providing a more predictable and less painful period for individuals. The different options available, such as birth control pills, patches, injections, and IUDs, offer a variety of choices for those seeking relief from dysmenorrhea symptoms.

Despite their numerous benefits, it is important to note that Hormonal Birth Control methods may come with potential side effects, such as nausea, weight gain, mood changes, and headaches. Individuals should consult with their healthcare provider to determine the most suitable contraceptive option based on their medical history and lifestyle.


Surgical interventions play a crucial role in the management of Secondary Dysmenorrhea by targeting the root cause of the condition. Common surgical procedures include laparoscopy, hysteroscopy, and laparotomy, depending on the specific gynecological issues identified. Indications for surgery in these cases often involve severe pain, suspected endometriosis, uterine fibroids, or structural abnormalities. By addressing these underlying factors through surgery, patients may experience significant relief from symptoms and improved overall well-being. The outcomes of these surgical interventions can vary. Still, many women report reduced pain levels and enhanced menstrual quality post-surgery.

Can Secondary Dysmenorrhea be Prevented?

Preventing Secondary Dysmenorrhea involves early detection and treatment of underlying gynecological conditions, maintaining a healthy lifestyle, and regular gynecological check-ups to monitor reproductive health and menstrual symptoms.

An important aspect of preventing Secondary Dysmenorrhea is recognizing the significance of early intervention. This entails proactively addressing any discomfort or abnormalities experienced during menstrual cycles.

Lifestyle factors also play a crucial role, including maintaining a balanced diet, regular exercise, and stress management techniques. Scheduling regular gynecological check-ups is essential for early diagnosis and treatment of any potential reproductive issues.

By taking these preventive measures, individuals can actively safeguard their reproductive well-being and mitigate the impact of Secondary Dysmenorrhea.


In conclusion, Secondary Dysmenorrhea is a complex gynecological condition that requires comprehensive evaluation, targeted treatment, and ongoing management to address the underlying causes of pelvic pain and menstrual disturbances effectively.

Healthcare providers must take a holistic approach when diagnosing and treating Secondary Dysmenorrhea. This involves collaborating with specialists such as gynecologists, pain management experts, and reproductive health professionals to develop a personalized care plan.

By considering the interconnected factors influencing gynecological health, including hormonal imbalances, pelvic disorders, and psychological aspects, a more tailored and effective treatment strategy can be implemented.

Regular monitoring and adjustments in treatment may be necessary to optimize outcomes and enhance the overall reproductive well-being of individuals affected by this condition.

About Period Pain Relief

Period Pain Relief – We focus on helping you get rid of period pain.

Get In Touch