What is the role of uterine leiomyomata in the etiology of secondary dysmenorrhea?

Updated: Sep 23, 2019
  • Author: Karim Anton Calis, PharmD, MPH, FASHP, FCCP; Chief Editor: Michel E Rivlin, MD  more...
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In the following sections, the more common causes of secondary dysmenorrhea are briefly summarized.

Uterine leiomyoma

Uterine leiomyomata are benign tumors of the uterine musculature that are a common cause of dysmenorrhea because they enlarge when stimulated by estrogen. They are up to 9 times more common in black women than in white women. [27]

In addition to pain with menses, patients may present with menorrhagia, abdominal distention, or pressure. Pelvic examination may reveal a uterine mass or irregularity. Ultrasonography is often used for determining size and location of fibroids, though computed tomography (CT) is used if ultrasonographic information is limited. [28, 29] Unless patients are symptomatic from profound anemia, these patients can be safely discharged with appropriate gynecologic follow-up. Potential complications are anemia and infertility. [30]

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