The gap between prevalence of primary dysmenorrhea and available treatment strategies.

Abstract: Primary dysmenorrhea is the cramping pain in the lower abdomen usually before or during menstruation. Although dysmenorrhea affects young girls and women of all ages, the etiology and treatment options are sparse and have limitations. Through a review of the existing literature, we document the history and elaborate on the mechanisms, diagnosis, and treatments related to dysmenorrhea. Based on cross-sectional studies, primary dysmenorrhea is a common issue affecting many women of reproductive age, often leading to absenteeism, and interfering with daily activities. Treatments such as non-steroidal anti-inflammatory drugs and oral contraceptives have been developed; however, they are not always effective, highlighting a gap between societal needs and available treatment options. To uncover the mechanisms underlying painful contractions, in vitro systems and animal models have been used, but they have limitations and do not fully replicate the condition, highlighting the gap between the prevalence of dysmenorrhea and our understanding of the etiology of dysmenorrhea and treatment options. A better understanding of the mechanisms that regulate uterine contractions through development of new model systems is needed to identify novel treatment approaches for dysmenorrhea. Lay summary: Primary dysmenorrhea or menstrual cramps are a common issue affecting many women of reproductive age, often leading to absenteeism, and interfering with daily activities. In our review, we highlight that treatments such as non-steroidal anti-inflammatory drugs and oral contraceptives have been developed; however, they are not always effective, highlighting a gap between societal needs and available treatment options. We also note that to uncover the mechanisms underlying painful contractions, in vitro systems and animal models have been used, but they have limitations and do not fully replicate the condition. Finally, we suggest that a better understanding of the mechanisms that regulate uterine contractions is needed to identify novel treatment approaches for dysmenorrhea.