In general, a mild feeling of cramping in the small abdomen during menstruation due to pelvic congestion is normal and not pathological. However, when the pain is severe enough to interfere with daily life and work, and requires medication, it is pathological. The prevalence of dysmenorrhea is about 33%, and overseas reports are as high as 50% or more, with a significantly higher incidence before the age of 19. What is dysmenorrhea? Dysmenorrhea refers to crampy pain in the lower abdomen before and after menstruation or during menstruation, often accompanied by systemic symptoms: breast pain, anal swelling, chest tightness, irritability, sadness, insomnia, headache, dizziness, nausea and vomiting, stomach pain and diarrhea, tiredness, pale face, cold limbs, cold sweat, fainting and other symptoms. Its high incidence, wide range, and great pain seriously affect the work and study of women and reduce the quality of life. Most dysmenorrhea appears at the time of menstruation, and in some cases it occurs a few days before menstruation. The abdominal pain increases after the onset of menstruation, and everything is normal after menstruation. There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea is called primary dysmenorrhea when detailed gynecological clinical examination fails to reveal any obvious abnormalities in the pelvic organs. Secondary dysmenorrhea is mostly caused by diseases, such as endometriosis, pelvic inflammatory disease, tumors, etc. Therefore, it is necessary to treat the cause of dysmenorrhea by examination and after determining the cause of the occurrence of dysmenorrhea. Dysmenorrhea in girls usually does not matter, unless it seriously affects life and study, and some painkillers should be used appropriately. The causes of primary dysmenorrhea are mostly mental tension and sensory allergy; weak constitution is also prone to dysmenorrhea, which can be relieved after improving the constitution; retention of menstrual blood due to poor uterine position and narrow cervical opening is also a common cause of dysmenorrhea, which can make the symptoms disappear after childbirth. However, some dysmenorrhea is caused by genital lesions, especially malformations of the reproductive tract, so more serious and persistent dysmenorrhea should be treated promptly. Be alert to the possibility that dysmenorrhea can mask a major problem. The pain of dysmenorrhea can last from one or two days to last the entire period, and in some severe cases, patients may have symptoms during non-menstrual periods. Even though it is so painful, some women still choose to endure it because they think menstrual pain is not a big deal. In some women, the symptoms of dysmenorrhea will gradually decrease, especially for those who have had dysmenorrhea since the first menstrual period, and the symptoms may decrease after marriage or childbirth. However, for those whose pain is getting worse and longer, prompt medical consultation is the right choice. Endometriosis and dysmenorrhea Endometriosis is a common condition in women of childbearing age, with an incidence of about 15%. Endometriosis is the main culprit in triggering severe menstrual pain in women. The pain can last from one or two days to last for the whole period, and some severe patients have symptoms during non-menstrual periods and experience varying degrees of painful intercourse, causing them to fear and avoid intercourse. In addition, endometriosis is the second leading cause of infertility, causing trouble and pain to countless families. Once developed, endometriosis is difficult to cure. As the disease progresses, some cysts rupture, causing severe pain and causing adhesions around the uterus, which can affect fertility. Endometriosis is found in various parts of the body, most commonly in the pelvis, especially the ovaries, and also in the scars of cesarean sections and perineal scars. The cause of endometriosis is still inconclusive, but it is generally believed to be closely related to menstrual reflux. If the patient marries and has children, the ectopic uterine membrane will shrink after pregnancy, making the condition less severe. Early treatment will not affect a woman’s fertility. Young women are advised to take menstrual pain seriously and avoid strenuous exercise during menstruation to avoid reflux of menstrual blood back into the pelvis along the fallopian tubes. Some endometriosis is intrinsic, i.e., myometriosis, and secondary progressive dysmenorrhea is its characteristic manifestation, accompanied by increased menstrual flow and prolonged periods. Dysmenorrhea in myometriosis is more pronounced and worsens. In some cases, medication fails to resolve the dysmenorrhea and eventually the uterus has to be removed. Endometriosis is a benign lesion, but has malignant behavior and a 0.7% to 1% malignancy rate, with the ovarian area being the most common. Therefore, early detection and treatment of endometriosis is of great importance to women of reproductive age, especially those who are infertile.