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Aetiology

Authoring team

The major elements involve are thought to be:

  • increased uterine activity:
    • may result from either excess synthesis of prostaglandins, or from increased myometrial sensitivity

  • ischaemia:
    • hypercontraction of the myometrium may reduce blood flow causing "uterine angina" and crampy pain

  • vasopressin:
    • this is often raised, and may be important as it increases both the synthesis of prostaglandins and myometrial activity
    • the role of vasopressin may help to explain why treatment with prostaglandin synthetase inhibitors is not always effective

  • psychological:
    • a mother may induce expectations in a daughter that menstruation is painful as a result of her own experiences

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