Dysmenorrhea

Dysmenorrhea is the medical term for painful menstruation, typically felt as cramping in the lower abdomen that may spread to the back and thighs.

Primary dysmenorrhea has no underlying disease and is driven by prostaglandins that make the uterus contract; it usually begins within a few years of the first period and is often accompanied by nausea, headache, fatigue or diarrhea. Secondary dysmenorrhea results from conditions such as endometriosis, fibroids or adenomyosis and tends to start later in life, last longer and worsen over time.

Assessment involves menstrual history and pelvic examination, with ultrasound or laparoscopy when a secondary cause is suspected. Standard care includes nonsteroidal anti-inflammatory drugs, heat, exercise and hormonal contraception. Cannabidiol-specific clinical evidence for menstrual pain is sparse, and current use is largely consumer-driven rather than guided by trials.