One probable cause of primary dysmenorrhea is attributed to excessive levels of prostaglandins. At the beginning of the menstrual cycle, the endometrium thickens to prepare for pregnancy. When there is no conception, the built-up uterine tissue is shed through menstruation, and prostaglandins are released due to the destruction of the endometrial cells. These hormones, responsible for pains response, cause the uterus to contract and discomfort occurs in the form of menstrual cramps. The excess in prostaglandins could also lead to a longer duration and increased severity of pain.
Other medical issues that can cause primary dysmenorrhea include a retroverted uterus (a uterus that tilts backward) and instances when the cervical canal is considerably narrow, inhibiting the release of endometrial tissue.
A woman’s lifestyle also contributes to the occurrence of primary dysmenorrhea. Unhealthy conditions and practices such as being overweight, lack of physical exercise, stressful activity, smoking, and alcohol consumption are common factors.
On the other hand, secondary dysmenorrhea can be caused by the following medical conditions: ovarian tumors, infection of the fallopian tubes, endomentriosis, sexually-transmitted infections, fibroids, adenomyosis, hormonal imbalance, imperforated hymen, and vaginal septum. And actions such as the use of intrauterine device and other invasive birth control methods as well as internal scarring can also cause menstrual pain.