Update on the diagnosis and treatment of dysmenorrhoea

Dysmenorrhea is defined as pain of uterine origin during menstruation. It's one of the most frequent symptoms in women of childbearing age and an important cause of school or work absenteeism as well as a frequent reason for scheduled or urgent consultation. In the diagnosis, it's of great importance to take an adequate anamnesis that includes personal and gynecological-obstetric history, detailed description of the pain and chronology regarding the beginning of menstrual bleeding and previous treatments. Ultrasound is not routinely indicated and is the test of choice in those cases in which pelvic pathology is suspected as the cause of dysmenorrhea. Both Paracetamol and NSAIDs have demonstrated superior efficacy in relieving pain compared to placebo. Hormonal treatment with either combined hormonal contraceptives or progestin-only contraceptives is considered an effective treatment for primary and secondary dysmenorrhea. The recent Organic Law 1/2023 provides for disabling dysmenorrhea to be covered by the temporary incapacity benefit through the creation of a new special type of this contingency «in order to reconcile the right to health with employment».