Painful menses, is common in reproductive-aged women and is divided into primary (physiologic) and secondary (pathologic) causes.

<aside> 💡 Primary dysmenorrhea is the most common cause of dysmenorrhea in general

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**Primary dysmenorrhea (**physiologic dysmenorrhea)

<aside> 💡 Primary dysmenorrhea can be diagnosed based on history alone and does not require physical examination. Physical examination is performed to evaluate for these possible causes; patients with abnormal examination findings (eg, adnexal mass, cervical motion tenderness) may require additional imaging (eg, pelvic ultrasound) and possible surgery (eg, laparoscopy).

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• patients with any of the following clinical features should be evaluated for secondary causes of dysmenorrhea:
• Secondary dysmenorrhea deferential
• EDUCATIONAL OBJECTIVES