Primary dysmenorrhea may also be differentiated from secondary dysmenorrhea by its rapid response to analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) as well as the nonprogressive, persistent severity of the pain and continued response to NSAID treatment.
The exclusion criteria of the study were secondary dysmenorrhea, presence of diabetes, mental and physical disorder, endocrine drug use, endometriosis, pregnancy or lactacion, smoking and alcohol use, thyroid and heart disease, intrauterine device (IUD), policystic ovary syndrome, oral contraceptives and antidepressant use.
Patients were excluded from the study if pathologies causing secondary dysmenorrhea existed, including: fibroids, adnexal masses (abscess, ovarian cyst, and hydrosalpinx), gynecological operation history, pelvic inflammatory disease history, presence of urinary or other infections, uterine anomaly, oral contraceptive use, alcohol and cigarette use, or nonsteroidal anti-inflammatory drug use in the last two days.
A 27-year-old woman (gravida I, para I; menarche at age 13) presented on 1 October 2017 due to secondary dysmenorrhea that she was suffering from since the age of 25, dyspareunia with back pain, constipation with perimenstrual tympanites, and contact bleeding in a case of known rectovaginal endometriosis.
(17) Patients were excluded if they had irregular menstrual cycles, used an intrauterine device (IUD) or oral contraceptive pill (OCP), undertook regular exercise, had a history of physical or psychological problems, and known secondary dysmenorrhea. (3)