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Primary dysmenorrhea in adolescents.

Daniela Ivanova Panova1, Aleksandra Atanasova Boshku2, Zoran B Stankovic3

  • 1Department for Reproductive Endocrinology and Pediatric and Adolescent Gynecology, University Clinic for Obstetrics and Gynecology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|February 28, 2026
PubMed
Summary

Primary dysmenorrhea is common in adolescents and often misdiagnosed. Early recognition and a step-by-step treatment approach are crucial for effective management and to rule out secondary causes like endometriosis.

Keywords:
Adolescent girlsPrimary dysmenorrheaStep-by step treatment chart

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Area of Science:

  • Gynecology
  • Adolescent Medicine
  • Pain Management

Background:

  • Dysmenorrhea is a frequent gynecological issue in adolescents.
  • Accurate diagnosis relies heavily on patient history, distinguishing primary from secondary causes.
  • Delayed diagnosis can result from various factors, impacting timely and appropriate care.

Purpose of the Study:

  • To provide a narrative review of primary dysmenorrhea in adolescents.
  • To discuss risk factors, pathophysiology, diagnosis, and treatment options.
  • To propose a treatment algorithm and emphasize reevaluation for secondary causes if initial therapy fails.

Main Methods:

  • Narrative review of existing literature on primary dysmenorrhea in adolescents.
  • Analysis of diagnostic challenges and treatment strategies.
  • Development of a step-by-step treatment algorithm.

Main Results:

  • Patient history is vital for diagnosing primary dysmenorrhea.
  • Over-the-counter medications can be an initial treatment based on history alone.
  • Reevaluation is necessary for cases unresponsive to initial treatment to identify secondary conditions like endometriosis.

Conclusions:

  • Increased awareness of primary dysmenorrhea and its management is needed among healthcare professionals and those working with adolescents.
  • A structured approach to diagnosis and treatment can improve outcomes.
  • Prompt identification and management of secondary causes are essential.