What underlying pathology is typically absent in primary dysmenorrhea?

Primary dysmenorrhea refers to the common menstrual pain that is not associated with any identifiable pelvic pathology. It is characterized by cramping pain occurring just before or during menstruation and is primarily due to the release of prostaglandins, which are hormone-like substances that cause uterine contractions. In this condition, the pain is considered functional, meaning that there is no underlying anatomical or pathological issue present.

While conditions like endometriosis, ovarian cysts, and uterine fibroids can cause secondary dysmenorrhea—where menstrual pain is due to identifiable conditions—those are not factors in primary dysmenorrhea. This distinction is crucial in clinical practice for guiding appropriate treatment options. Hence, understanding that primary dysmenorrhea occurs in the absence of any pathology clarifies that these associated conditions do not contribute to this type of menstrual pain.