Current concepts of primary dysmenorrhea

Menstruation, a physiologic function, should be free of organic or psychic discomfort, but often it is not. As to somatic causes, much has been postulated, little proved. There is evidence that somatic dysmenorrhea is caused by action of progesterone upon the uterus. And there is indication also that the cause may lie in some abnormality of the cervix or abnormal effect upon it. Traditional association of menstruation with "illness," "curse" and the like is indicative of the psychic roots of dysmenorrhea. It has been observed that there is striking parallel between dysmenorrhea in adulthood and psychological maladjustment in childhood. Cure of psychogenic dysmenorrhea may be difficult. Proper anticipation-emotional preparation of the girl from infancy on, then sound instruction in biologic fact-would seem to be a major means of prevention.