Primary dysmenorrhoea describes painful menstruation in the absence of detectable pelvic pathology.
It generally starts a year or so after menarche once ovulatory cycles are established. The peak incidence is between 15 and 25 years of age.
The patient complains of cramping pain in the lower abdomen which may radiate to the inner surface of the thighs and lower back. Pain is usually first noticed about 24 hours before menstruation and rarely persists for more than 48 - 72 hours. It may be accompanied by nausea, vomiting and diarrhoea.
Symptoms usually decrease with age.
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