Definition and self-reported pain intensity in adolescents with dysmenorrhea: A debate report

Background: Dysmenorrhea is one of the most common complaints among adolescents and women. Pathophysiologically, it is categorized into primary and secondary dysmenorrhea. Primary dysmenorrhea (PD) refers to pain with no obvious pathological pelvic disease, secondary dysmenorrhea (SD) is caused by an underlying pelvic conditions or pathology. The prevalence of primary dysmenorrhea varies between 67% and 90% in adolescents, with severe pain perceived in 7%-15% of the women studied. The lowest prevalence of 16% was reported in a random sample of Japanese women aged 17-51 years through daily diary recording for 1 month. The highest prevalence of 91% was reported in a random sample of Iranian women aged 16-56 years, with the majority younger than 30 years of age without children. The prevalence of primary dysmenorrhoea is difficult to determine because many affected women do not seek medical treatment. The majority accept pain as a part of their normal menstrual cycle. Aim of the study: The authors reviewed the epidemiology data reported in the literature on 4 aspects of dysmenorrhea: definition, pain severity, prevalence and development of chronic pain. Results: The authors highlight the necessity for finding a uniform definition of dysmenorrhea. The wide variation in the prevalence rates may be due to using different definitions, employing selected groups of subjects and/or the absence of a universally established method for measuring pain. Variation in the methods that assess the severity of dysmenorrhea (ranging from occasional menstrual cramps to severe pain that interferes with daily activities and/or to require medication) adds to the variation in the prevalence among different studies. Conclusions: Studying the epidemiology of menstrual pain is an important issue that deserves further attention because of its high prevalence and negative effect on women health.