aetiology
Last reviewed 01/2018
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