What is a primary factor in causing primary dysmenorrhea?

Primary dysmenorrhea is a common condition characterized by painful menstrual cramps that occur in the absence of any underlying pelvic pathology. The primary factor that contributes to this condition is an increase in prostaglandin levels.

Prostaglandins are hormone-like substances that are produced by the endometrium (the lining of the uterus) and play a critical role in the regulation of menstruation. During menstruation, higher levels of prostaglandins are associated with increased myometrial contractions, leading to the cramps typically experienced during this time. These contractions can also reduce blood flow to the uterus, causing pain and discomfort.

In contrast, cervical stenosis, ovarian cysts, and fibroids are associated with secondary dysmenorrhea, which is menstrual pain caused by identifiable pelvic conditions. In primary dysmenorrhea, there are no anatomical abnormalities or underlying conditions, making the role of increased prostaglandins central to its pathophysiology.

Thus, understanding that elevated prostaglandin levels are the main contributing factor helps clarify the nature of primary dysmenorrhea and differentiates it from secondary causes of menstrual pain.