Overproduction of PGs was observed in women with primary dysmenorrhea which is responsible for increased smooth muscle contraction of the uterus and causes painful menstruation. PGs are synthesized from arachidonic acid through the cyclooxygenase (COX) pathway. The drop in progesterone in the menstrual cycle after ovulation before the start of menses increases the formation of omega-6 fatty acid particularly arachidonic acid in the phospholipids of the cell membrane. 16– 18Ĭurrent evidence showed that the root cause of primary dysmenorrhea is mainly related to the level of prostaglandins (PGs) production in the uterus during menstruation. It is a cause for female students’ school absenteeism and/or reduced class concentration and participation ability leading to poor school performance. As a result, primary dysmenorrhea has a medical and psychosocial effect on adolescent girls. Though primary dysmenorrhea is one of the most common gynecologic complaints of adolescent and young females, it is poorly understood by many girls that they simply accept it as a normal part of their menstrual cycle. The prevalence reaches up to 85.4% among university students.
7– 10 Studies from Ethiopia reported that about 70% of school girls experienced some form of primary dysmenorrhea and up to 12% had severe pain. It ranges from 41.7% to 93.3% and the severe form of dysmenorrhea accounts for 10% to 20% in the world. As a result, the prevalence varies significantly from place to place. 5– 7 Due to the lack of a standard method to measure menstrual pain and the subjectivity nature of pain levels across individuals studies across the world used various methods to measure the amount and severity of primary dysmenorrhea. Primary dysmenorrhea has a wide range of severity with significant medical and psychosocial implications. Secondary dysmenorrhea is also menstrual pain caused by underlying pelvic pathology which usually occurred on relatively older reproductive-age women. The pain starts a few hours before or after the onset of menstruation and lasts for a few hours to 2–3 days. Primary dysmenorrhea is lower abdominal pain associated with the normal ovulatory cycle in the absence of pelvic disease or abnormality. It is categorized into primary and secondary. Dysmenorrhea is defined as a recurrent lower abdominal pain during menstruation.
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