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Secondary Dysmenorrhea: Symptoms, Causes, and Treatment 

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Secondary Dysmenorrhea is a medical condition characterized by the pain that many women or Assigned Females at Birth (AFAB) experience during menstruation or periods. It is often caused by an underlying health issue or structural defects of the uterus or its surrounding tissues. 

The condition can cause varying degrees of pain and may be accompanied by additional symptoms such as mood swings and fatigue. Pain caused by Secondary Dysmenorrhea usually appears sooner during menstruation and lasts longer than regular menstrual cramps.

Understanding the causes, symptoms, and treatment strategies for the condition is essential for effective management and relief. 

This article will provide all the necessary information that you need to know about Secondary Dysmenorrhea.

Secondary Dysmenorrhea Symptoms and Causes

Secondary Dysmenorrhea is a type of Dysmenorrhea that affects millions of people worldwide, causing major discomfort and impairing normal activities during menstruation

In contrast to Primary Dysmenorrhea, which is more prevalent and usually begins shortly after menarche (beginning of menstruation for the first time), Secondary Dysmenorrhea occurs later in life and frequently indicates an underlying medical issue, leading to abdominal pain, pain in the lower back, vomiting, and nausea.

The most common causes of Secondary Dysmenorrhea include Endometriosis, Adenomyosis, Uterine fibroids, Pelvic Inflammatory Disease (PID), and Ovarian cysts.

Let’s further discuss these causes in detail.

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  • Endometriosis

    Endometriosis is one of the major causes of Secondary Dysmenorrhea. It is characterized by the formation of tissue identical to that of the uterine lining (Endometrium) outside the uterus. 

    During menstruation, the tissue formed due to Endometriosis responds to hormonal fluctuations similarly to the Endometrium that lines the uterus. However, unlike Endometrial tissues, this newly formed tissue can’t leave the body, resulting in inflammation, scarring, and pain during periods.

    Do you know?
    Globally, approximately two-thirds of young people with severe abdominal cramps are subsequently diagnosed with Endometriosis.


    Adenomyosis is a disorder in which the Endometrial tissue that typically surrounds the uterus grows into the uterine muscular wall, leading to uterine enlargement and inflammation. 

    This inflammation can cause more powerful uterine contractions during menstruation, resulting in more severe and extended menstrual cramps than those observed in Primary Dysmenorrhea.

    Uterine Fibroids

    These are noncancerous tumors that form inside or on the surface of the uterus, altering its shape and size. This distortion might interfere with the regular contractions of the uterus during menstruation, resulting in more severe and prolonged pain during menstruation.

    Pelvic Inflammatory Disease (PID)

    woman suffering from pid pain in lower backSource: getty_images
    Woman suffering from PID pain

    PID is an infection that affects one or more of the upper reproductive organs, such as the uterus, fallopian tubes, and ovaries. This inflammation can result in the development of scar tissue in the inflamed reproductive organs. 

    As a result, the usual movement and functioning of these organs may be disrupted, causing painful periods. However, PID can be effectively treated with antibiotics, thus lowering the likelihood of developing the pain. Read What Antibiotics Treat Pelvic Inflammatory Disease: Revealed 

    Ovarian Cysts

    Ovarian cysts are fluid-filled sacs that form on the ovaries. Larger cysts might disrupt the normal structure of the ovary. This, in turn, causes greater stress and pressure in the region, resulting in Secondary Dysmenorrhea.

    It is essential to learn about the exact causes behind the condition. This is because the symptoms of this condition might vary based on the causes. However, there are some common symptoms of this condition that you need to know about.

    Let us take a close look at the common causes of Secondary Dysmenorrhea.

    • Menstrual cramps that are severe and can worsen with time
    • Pain in the pelvic region that might spread to the lower back or thighs
    • Prolonged menstrual bleeding or period inconsistencies
    • Pain during sexual intercourse
    • Gastrointestinal issues like bloating, Diarrhea, and constipation
    • Tiredness and mood swings

    Secondary Dysmenorrhea Treatment

    The diagnosis of Secondary Dysmenorrhea requires a thorough medical examination as well as a study of the patient’s medical history. Your doctor may also carry out other tests, such as ultrasound, MRI, or laparoscopy, to identify the underlying cause of the condition.

    The treatment focuses on addressing the underlying cause and overcoming the associated symptoms. Depending on the cause, treatment options may include medications, surgery, and lifestyle changes.


    Over-the-counter Nonsteroidal Anti-inflammatory medicines (NSAIDs), such as Ibuprofen or Naproxen, are frequently used as the first-line treatment for Secondary Dysmenorrhea. These medicines can help relieve menstruation pain and inflammation.

    Apart from NSAIDs, hormonal contraception, including birth control tablets, patches, and hormonal Intrauterine Devices (IUDs), can help balance the menstrual cycle and ease pain caused by Secondary Dysmenorrhea. This can be achieved by inhibiting ovulation and thinning the uterine lining, resulting in shorter and less painful cycles. 

    If Secondary Dysmenorrhea is caused by PID, antibiotics are recommended to treat the infection and decrease inflammation. 

    However, other treatments can also be employed to treat PID related Secondary Dysmenorrhea. To learn about the treatment of PID in detail, read Exploring Pelvic Inflammatory Disease Treatments.


    If Secondary Dysmenorrhea is caused by structural problems such as Endometriosis, Adenomyosis, or uterine fibroids, surgery may be required. Surgical techniques, such as Laparoscopy or Hysterectomy, can relieve pain and other symptoms by removing unwanted tissue growths, scars, or the uterus itself.

    Lifestyle Changes

    sleeping womanSource: Susannah Townsend from baseimage
    Sleeping woman

    Adopting a healthy lifestyle can also aid in reducing pain and other symptoms linked to Secondary Dysmenorrhea. These approaches may include:

    • Regular exercise
    • Stress reduction strategies like yoga or meditation
    • Adequate sleep
    • A well-balanced diet containing fruits, vegetables, and whole grains
    • Heat therapy, such as using heating pads or taking warm baths, can help relax pelvic muscles and alleviate menstrual cramps
    Discontinuation of medications without consulting a doctor can lead to potential side effects. Always consult your doctor before starting or stopping any medication.


    Secondary Dysmenorrhea, or menstrual pain, can significantly affect everyday living and quality of life. The severe pain and discomfort brought on by menstruation might indicate underlying medical disorders such as Endometriosis, Adenomyosis, PID, or uterine fibroids. 

    The pain is often associated with other symptoms like mood swings, fatigue, and gastrointestinal issues. However, with the right evaluation and treatment, relief is achievable. 

    Pain management with NSAIDs, hormone therapy, and surgery are the available treatment options for Secondary Dysmenorrhea. Additionally, lifestyle changes and pain management strategies can all help control symptoms and improve overall health. 

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    Frequently Asked Questions

    Is Secondary Dysmenorrhea dangerous?

    No, Secondary Dysmenorrhea is not harmful in itself. However, the underlying problems, such as Endometriosis, PID, and uterine fibroids, that lead to it can have major consequences for reproductive health and overall well-being if not addressed on time.

    How long does Secondary Dysmenorrhea last?

    Compared to regular menstrual cramps, Secondary Dysmenorrhea pain typically lasts longer than normal menstrual pain. It might start a few days before your period and continue until the bleeding ends completely.

    Is there any connection between Secondary Dysmenorrhea and pregnancy?

    Yes, Secondary Dysmenorrhea can cause trouble getting pregnant if caused by a medical condition like PID. If left untreated, the infection can lead to the fallopian tube, causing damage and scarring, thus increasing the risk of infertility or ectopic pregnancy.

    Can Secondary Dysmenorrhea cause infertility?

    Yes, Secondary Dysmenorrhea caused by Endometriosis, PID, and uterine fibroids makes you more prone to infertility by causing damage to reproductive organs.

    How does Secondary Dysmenorrhea differ from primary Dysmenorrhea? 

    Primary Dysmenorrhea is menstrual pain that occurs due to the normal hormonal changes associated with menstruation and without any underlying medical cause. Whereas Secondary Dysmenorrhea is caused by medical health issues like Endometriosis, PID, and uterine fibroids.

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    Photo of author Janet Fudge
    Janet Fudge is a highly skilled and experienced pharmacologist who serves as a contributing writer for With a strong academic background from a premier US University and a passion for helping others, Janet has become a trusted voice in the pharmaceutical world. After completing her Doctor of Pharmacy degree, Janet embarked on a successful career in the pharmaceutical industry, working with various clients, including hospitals, retail pharmacies, and drug manufacturers. Her in-depth knowledge of pharmacology and dedication to patient-centered care has led her to excel in her field. As a writer for, Janet uses her wealth of expertise to provide readers with accurate, reliable, and up-to-date information on various topics related to medicine and healthcare. Her engaging writing style and ability to break down complex topics into easily digestible content make her a valuable resource for healthcare professionals and the general public.
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