Primary dysmenorrhea in adolescents

Dysmenorrhea is among the most common gynecological complaints in adolescents. Its diagnosis depends on the exclusion of other underlying pathologies, with the patient's history playing a crucial role. Initial therapy with over-the-counter medications can be initiated solely based on the patient's history. However, factors such as adolescents not seeking care, reliance on family advice, or incomplete evaluations by healthcare providers may contribute to misdiagnosis, leading to delays in both appropriate diagnosis and management. This article presents a narrative review of primary dysmenorrhea in adolescents, addressing its risk factors, pathophysiology, potential underlying conditions, diagnostic approaches, and treatment options. A step-by-step treatment algorithm for primary dysmenorrhea is also proposed, emphasizing that cases unresponsive to initial therapy should prompt reevaluation for secondary causes, such as endometriosis. This review urges healthcare professionals and others working with adolescents to increase awareness of primary dysmenorrhea and its management.