The Clinical Classification and Causes of Dysmenorrhea

Unlike many conditions in medicine, the classification of painful menstruation into primary and secondary dysmenorrhea is not based on the temporal appearance of symptoms or the condition, as it is in primary and secondary amenorrhea, or primary and secondary infertility. The taxonomy of primary and secondary dysmenorrhea is based upon the absence or presence (respectively) of clinically identifiable causes. In both cases, a great deal is known about the pathophysiology underlying the development of menstrual pain. It is, therefore, not an issue of a lack of identifiable causation; it is the lack of clinically identifiable processes that drive the assignment.