What are the signs and symptoms 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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The following may indicate secondary dysmenorrhea [1, 2] :

  • Dysmenorrhea beginning in the 20s or 30s, after relatively painless menstrual cycles in the past

  • Heavy menstrual flow or irregular bleeding

  • Dysmenorrhea occurring during the first or second cycles after menarche, which may indicate congenital outflow obstruction

  • Pelvic abnormality with physical examination (consider endometriosis, pelvic inflammatory disease [PID], pelvic adhesions, and adenomyosis)

  • Little or no response to nonsteroidal anti-inflammatory drugs (NSAIDs) or OCs

  • Infertility

  • Dyspareunia

  • Vaginal discharge

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