• Secondary dysmenorrhea is related to cramping caused by an underlying health condition, such as endometriosis, ovarian cysts or uterine fibroids. (nortonhealthcare.com)
  • There are two types of dysmenorrhea, primary and secondary, based on the absence or presence of an underlying cause. (wikipedia.org)
  • Primary dysmenorrhea occurs without an associated underlying condition, while secondary dysmenorrhea has a specific underlying cause, typically a condition that affects the uterus or other reproductive organs. (wikipedia.org)
  • Secondary dysmenorrhea is the type of dysmenorrhea caused by another condition such as endometriosis, uterine fibroids, uterine adenomyosis, and polycystic ovary syndrome. (wikipedia.org)
  • If the pain occurs between menstrual periods, lasts longer than the first few days of the period, or is not adequately relieved by the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives, this could indicate another condition causing secondary dysmenorrhea. (wikipedia.org)
  • Membranous dysmenorrhea is a type of secondary dysmenorrhea in which the entire lining of the uterus is shed all at once rather than over the course of several days as is typical. (wikipedia.org)
  • Other causes of secondary dysmenorrhea include leiomyoma, adenomyosis, ovarian cysts, pelvic congestion, and cavitated and accessory uterine mass. (wikipedia.org)
  • If symptoms are not improved, other concerning symptoms or signs occur, or in cases of secondary dysmenorrhea, a complete physical examination should be performed. (medscape.com)
  • Treatment of secondary dysmenorrhea involves correction of the underlying organic cause. (medscape.com)
  • Dysmenorrhea can be divided into 2 broad categories: primary (spasmodic) and secondary (congestive). (medscape.com)
  • ABSTRACT To examine the prevalence, determinants, impact and treatment practices of dysmenorrhoea, we studied 664 female students in secondary schools in urban and rural areas. (who.int)
  • The target population was arrhoea, a bloated feeling, nausea and vom- female secondary-school students enrolled iting, backache and leg pains. (who.int)
  • Secondary dysmenorrhoea, on the oth- school were selected from Mansoura city. (who.int)
  • In contrast to primary dysmenorrhea, secondary dysmenorrhea is pain that arises due to disorders of the reproductive organs. (nonawoman.com)
  • The pain in secondary dysmenorrhea feels worse as the menstrual period progresses. (nonawoman.com)
  • Secondary dysmenorrhea is a form of the disorder caused by infection, disease, or abnormalities in the reproductive organs. (fibromyalgia-symptoms.org)
  • Most women who have secondary dysmenorrhea have had normal and painless menstrual cycles at some point in their lives. (fibromyalgia-symptoms.org)
  • Secondary dysmenorrhea also causes severe abdominal pain and cramps but the pain tends to onset earlier than in primary dysmenorrhea. (fibromyalgia-symptoms.org)
  • Secondary dysmenorrhea is menstrual pain that develops later in women who have had normal periods. (medlineplus.gov)
  • If efforts to treat primary dysmenorrhea are unsuccessful after a few months, then the diagnosis, and the possibility of secondary causes, should be reconsidered. (studentnow.com)
  • Surgery is required only when the dysmenorrhea is found to be secondary to an underlying cause. (studentnow.com)
  • Primary dysmenorrhea means there is no gynecological problem causing the cramping and secondary dysmenorrhea means there is some condition usually associated with the woman's reproductive system that contributes to the pain she is experiencing. (gynob.com)
  • Secondary dysmenorrhea may be caused by endometriosis, uterine fibroids, adenomyosis (a condition in which the cells of the inner uterine lining invade its wall), pelvic inflammatory disease, adhesions or an IUD that doesn't have hormones in it. (gynob.com)
  • It is more common than secondary dysmenorrhea. (msdmanuals.com)
  • Secondary dysmenorrhea usually starts during adulthood (unless it is caused by a birth defect of the reproductive system). (msdmanuals.com)
  • Secondary dysmenorrhea is caused by abnormalities in the reproductive system. (msdmanuals.com)
  • Endometriosis is the most common cause of secondary dysmenorrhea. (msdmanuals.com)
  • When a reproductive disorder causes menstrual pain, it's called secondary dysmenorrhea. (whattoexpect.com)
  • With secondary dysmenorrhea, cramps may start just before your period begins, get more intense during your period and may keep occurring after your period ends. (whattoexpect.com)
  • Among adolescents and young women, an estimated 10 percent also have secondary dysmenorrhea. (whattoexpect.com)
  • The most common cause behind secondary dysmenorrhea, endometriosis affects an estimated 10 to 15 percent of all women between the ages of 15 and 44. (whattoexpect.com)
  • Many women have painful periods, also called dysmenorrhea. (nih.gov)
  • Dysmenorrh0ea, or "painful periods," is one of the most common problems that women face, affecting more than 50 percent of those who menstruate. (alive.com)
  • This is why more and more women are looking for safe and effective natural treatments to help relieve painful periods. (alive.com)
  • Most women with primary dysmenorrhea have never had painless menstrual periods. (fibromyalgia-symptoms.org)
  • Painful menstrual periods are periods in which a woman has crampy lower abdominal pain, which can be sharp or aching and come and go. (medlineplus.gov)
  • Many women have painful periods. (medlineplus.gov)
  • Primary dysmenorrhea is menstrual pain that occurs around the time that menstrual periods first begin in otherwise healthy young women. (medlineplus.gov)
  • Dysmenorrhea, menstrual cramps or painful periods is the commonest menstrual disorder. (medindia.net)
  • Painful menstrual periods occur frequently on women, particularly in young women where 50 to 75percent suffer from dysmenorrhea,' according to study lead author, Dr. Ingela Lindh. (affleap.com)
  • This is the cycle of fertility that affects most females from their teenage years through to menopause , when periods stop. (medicalnewstoday.com)
  • Primary dysmenorrhoea - when periods have been painful since menarche - usually does not have an identified pathological cause and the focus at remote consultation should be on management. (pulsetoday.co.uk)
  • Women with painful periods show increased sensitivity to pain throughout their cycles, even when there is no background period pain. (sciencedaily.com)
  • The Oxford researchers in the Nuffield Department of Obstetrics and Gynaecology and the Centre for Functional Magnetic Resonance Imaging of the Brain applied hot pads to the inner arm and abdomen of 12 women with painful periods (but who were otherwise healthy), and 12 women without, while they were in an MRI scanner. (sciencedaily.com)
  • The team found that the group of women with painful periods were more sensitive to the hot pads -- the pads didn't have to be turned up as far to get the same reports of pain.The brain imaging data revealed that women who experience period pain showed changes in activity in brain areas known to be involved in the pain response. (sciencedaily.com)
  • The women with painful periods also reported reduced quality of life suggesting the period pain may interfere with physical activity such as sport and work, although this is a small study for identifying such effects. (sciencedaily.com)
  • Many of the features of chronic pain conditions are present in women with painful periods, even though the pain is experienced for just a few days every month,' says Dr Katy Vincent, a clinical lecturer in the Nuffield Department of Obstetrics and Gynaecology at Oxford University and first author on the paper. (sciencedaily.com)
  • Those that release a progestin (a synthetic form of the female hormone progesterone ) usually do not cause painful periods. (msdmanuals.com)
  • Dysmenorrhoea is not considered a chronic pain condition, but is associated with enhanced behavioural responses to experimental noxious stimuli. (ox.ac.uk)
  • Thus, many features of chronic pain conditions are also seen in women with dysmenorrhoea: specifically a reduction in quality of life, suppression of the hypothalamic-pituitary-adrenal axis, and alterations in the central processing of experimental noxious stimuli. (ox.ac.uk)
  • Cortical mechanisms of visual hypersensitivity in women at risk for chronic pelvic pain. (luc.edu)
  • Despite the number of possible causes, many women with chronic pelvic pain receive no diagnosis. (healthywomen.org)
  • In a longitudinal population study of 9,067 Australian women, researchers found that those who began smoking by age 13 had the greatest risk of developing chronic dysmenorrhea. (medscape.com)
  • The dysmenorrhea, dyspareunia, and chronic pelvic pain VAS scores all showed significant worsening from month 6 to 24 in the non-user group when compared with those in the continuous OC users. (medscape.com)
  • 1 No statistical data for the prevalence of PPP in Australia are available, but estimates of community prevalence in women range from 15% (USA) 2 to 25.4% (New Zealand). (racgp.org.au)
  • Conclusions There is a high prevalence of undiagnosed menstrual disturbances among Saudi university women. (researchgate.net)
  • The overall prevalence of dysmenorrhea was 60%, with 74% of those with the highest level of stress reporting this problem. (cdc.gov)
  • 3) had the following prevalence and mean values on the VAS scale, respectively: dysmenorrhea in 84.7% (6.9), dyspareunia in 69.1%, (4.5), menstrual dyschezia in 60.7% (4.3) and menstrual dysuria in 35.7% of patients. (bvsalud.org)
  • The aim of this study was to assess the prevalence of dysmenorrhoea among adolescent girls in Sidon city and suburbs, Lebanon, and to explore its possible relationship with menstrual experience. (who.int)
  • Dysmenorrhea, https://pubmed.ncbi.nlm.nih.gov/32809669/#affiliation-1 (2022, accessed 20 August 2022). (pbbmi.org)
  • LOS ANGELES, CA, UNITED STATES, November 8, 2022 / EINPresswire.com / -- Gardasil vaccine attorneys from Baum Hedlund Aristei & Goldman have filed a lawsuit on behalf of a Southern California woman who alleges she developed postural orthostatic tachycardia syndrome (POTS) and associated symptoms after receiving the human papillomavirus (HPV) vaccine. (einpresswire.com)
  • Significant predictors of dysmenorrhoea were older age, irregular or long cycle and heavy bleeding. (who.int)
  • Significant predictors of dysmenorrhoea were negative menstrual experience, younger age of girl, longer duration of bleeding and longer cycle length. (who.int)
  • Primary dysmenorrhea is a normal cramping of the lower abdomen caused by hormone-induced uterine contractions before the period. (nih.gov)
  • 5-15% of women with dysmenorrhea experience symptoms severe enough to interfere with daily activities. (wikipedia.org)
  • No limitation of activities was reported by 47.4% of student with dysmenorrhoea, but this was significantly more reported by students with severe dysmenorrhoea. (who.int)
  • Ten percent of women have severe enough symptoms to necessitate missing work, school or other responsibilities. (studentnow.com)
  • If the pain is severe, or sudden in onset but not midcycle - which is suggestive of ovulation pain (Mittleschmirtz) - the woman may require same-day emergency care in case of an ovarian accident, such as torsion or rupture. (pulsetoday.co.uk)
  • Primary dysmenorrhea usually starts during adolescence and may become less severe with age and after pregnancy. (msdmanuals.com)
  • In about 5 to 15% of these women, cramps are severe enough to interfere with daily activities and may cause them to miss school or work. (msdmanuals.com)
  • It addresses the health conditions that are specific to or more prevalent in women, have severe consequences and imply certain risk factors. (who.int)
  • Because pain is likely to return with bleeding, continuous use is expected to lead to less frequent and less severe dysmenorrhea, the main finding of this study. (medscape.com)
  • Primary dysmenorrhea is the result of the uterus's overproduction of prostaglandins, which are hormones that help the uterus to contract. (fibromyalgia-symptoms.org)
  • Reproductive hormones in plasma over the menstrual cycle in primary dysmenorrhea compared with healthy subjects. (pbbmi.org)
  • This chapter describes the different parts of the female reproductive system: the organs involved in the process of reproduction, hormones that regulate a woman's body, the menstrual cycle, ovulation and pregnancy, the female's role in genetic division, birth control, sexually transmitted diseases and other diseases and disorders. (wikibooks.org)
  • They are the primary female sex hormones. (absoluteastronomy.com)
  • This is the rise and fall of hormones, such as estrogen and progesterone , that influence female fertility over the course of around 21-35 days . (medicalnewstoday.com)
  • Women experiencing dysmenorrhea accompanied by abdominal cramps originating from uterine muscle contractions can lead to muscle tension and cause pain that adversely affects daily activities. (risetpress.com)
  • No tests are specific to the diagnosis of primary dysmenorrhea. (medscape.com)
  • What kinds of medical tests are used to establish the diagnosis of dysmenorrhea? (studentnow.com)
  • Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates. (pbbmi.org)
  • Few women (7.7%) reported a previous diagnosis of polycystic ovary disease. (researchgate.net)
  • In fact, many women with CPP collect a different diagnosis from each specialist they see. (healthywomen.org)
  • These women may feel that the pain is somehow their fault, when, in fact, the lack of a diagnosis represents the limitations of medical science. (healthywomen.org)
  • Diagnosis and appropriate correction of intrauterine anomalies are considered et d'Application en Chirurgie essential in order to increase chances of conception. (who.int)
  • The plasma MDA is increased in adolescent females with primary dysmenorrhea. (pbbmi.org)
  • Approximately 27% of these cases are in women and adolescent girls who have been exposed through heterosexual transmission, injection drug use, sex with an injection drug user, or other unspecified risk. (cdc.gov)
  • Dysmenorrhea is another term for pain associated with the menstrual period, also known as period pain. (nortonhealthcare.com)
  • Many women experience menstrual cramps for a couple of days during each cycle - but not all pain is normal," said Rosemary C. Sousa, M.D. , OB/GYN with Norton Women's Care. (nortonhealthcare.com)
  • The main symptom of dysmenorrhea is pain concentrated in the lower abdomen or pelvis. (wikipedia.org)
  • Dysmenorrhea is associated with increased pain sensitivity and heavy menstrual bleeding. (wikipedia.org)
  • Primary dysmenorrhea is defined as menstrual pain that is not associated with macroscopic pelvic pathology (ie, occurs in the absence of pelvic disease). (medscape.com)
  • Almost every woman will experience dysmenorrhea or menstrual pain. (nonawoman.com)
  • However, for some women this pain can interfere with their daily activities. (nonawoman.com)
  • In this condition, dysmenorrhea sufferers will feel cramps or pain that lasts longer than primary dysmenorrhea. (nonawoman.com)
  • After applying it, the women who used the essential oil experienced greater relief from menstrual pain compared to the women who used almond oil. (nonawoman.com)
  • Heart disease is concerning because women often ignore the symptoms, which may include fatigue, thoracic spine pain and lower extremity edema. (chiroeco.com)
  • Breast pain in women can be caused by many factors, most of which are not serious health threats… What is breast pain in women? (familydoctor.org)
  • Dysmenorrhea is the medical term for pain that women have before or during menses (known as their period). (familydoctor.org)
  • Although these drugs can be effective for many women at reducing pain, they come with a number of side effects. (alive.com)
  • In the case of dysmenorrhoea, eliminating foods high in arachidonic acid is often the key to dealing with the pain. (alive.com)
  • Studies have found that supplementation with omega-3 fatty acids can be effective in alleviating symptoms of dysmenorrhoea such as abdominal pain and low back pain. (alive.com)
  • Because of this increased sensitivity to pain, fibromyalgia often results in dysmenorrhea in many women. (fibromyalgia-symptoms.org)
  • Dysmenorrhea is a disorder that causes excruciating pain in the abdomen, pelvis and other areas of the body during your menstrual cycle. (fibromyalgia-symptoms.org)
  • Unfortunately, dysmenorrhea often affects fibromyalgia patients and may make your symptoms of pain and fatigue even worse. (fibromyalgia-symptoms.org)
  • The pain of primary dysmenorrhea usually begins 24 hours before your period begins. (fibromyalgia-symptoms.org)
  • To compare the effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. (nih.gov)
  • Ginger was as effective as mefenamic acid and ibuprofen in relieving pain in women with primary dysmenorrhea. (nih.gov)
  • Dysmenorrhea and pelvic pain in adolescents. (studentnow.com)
  • Persistent pelvic pain (PPP) is estimated to affect 15-25% of women. (racgp.org.au)
  • A GP with an interest in this area is in a good position to effectively care for the majority of women with pelvic pain, in conjunction with other health professionals including gynaecologists, pelvic physiotherapists, psychologists, pain physicians, dieticians and urologists as required. (racgp.org.au)
  • A woman with PPP may have had pain for many years. (racgp.org.au)
  • Without background pain (ie, in nonmenstrual phases), activity in the entorhinal cortex appeared to mediate the increased responses in women with dysmenorrhoea. (ox.ac.uk)
  • Maladaptive neuroplasticity of the descending pain modulatory systems in dysmenorrhic women that might be relevant to the development of co-occurring functional disorders later in life. (lww.com)
  • Menstrual pain is the most prevalent gynecological complaint, and is usually without organic cause (termed primary dysmenorrhea, PDM). (nycu.edu.tw)
  • The high comorbidity in the later life of PDM with many functional pain disorders (associated with central dysfunction of pain inhibition, eg, fibromyalgia) suggests possible maladaptive functionality of pain modulatory systems already occurred in young PDM women, making them vulnerable to functional pain disorders. (nycu.edu.tw)
  • Based on the research findings, it can be concluded that Core Strengthening Exercise is more effective than Slow Stroke Back Massage in reducing dysmenorrheal pain in female university students. (risetpress.com)
  • However, given the anatomical proximity of the bladder, recto-sigmoid, ureters and ovaries, women may not be able to distinguish the pain source. (pulsetoday.co.uk)
  • Somatic symptoms in women with dysmenorrhea and non-cylic pelvic pain. (luc.edu)
  • Meanwhile, period pain (also called dysmenorrhea ) is another common symptom. (healthline.com)
  • These low levels persisted throughout the women's menstrual cycles and were correlated with the length of time women had experienced period pain. (sciencedaily.com)
  • In either case, the pain is felt internally, not externally as in another common pain disorder in women called vulvodynia. (healthywomen.org)
  • These are often the women who make the rounds of various specialists seeking relief, only to be told the pain is 'all in their heads. (healthywomen.org)
  • That said, they're also extremely common: More than half of all women who menstruate experience period pain. (whattoexpect.com)
  • CONCLUSION: CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. (bvsalud.org)
  • This study aimed to examine the potential feasibility of an online hypnotic intervention for women with persistent pelvic pain. (bvsalud.org)
  • Twenty women with persistent pelvic pain completed assessment questionnaires and were recruited from a variety of social media sites related to persistent pelvic pain and randomized to either control or hypnotic intervention groups. (bvsalud.org)
  • This randomized controlled trial assessed the benefits of postoperative cyclic or continuous OC use for reducing pain recurrence in 311 women undergoing surgery for ovarian endometriomas. (medscape.com)
  • Harel Z. Dysmenorrhea in adolescents and young adults: etiology and management. (pbbmi.org)
  • Estimates vary, but can they can affect up to 90% of women at some time in their lives and are particularly common among adolescents and young women. (sciencedaily.com)
  • A verbal multidimensional scoring system was used for assessing the severity of primary dysmenorrhea. (nih.gov)
  • Among heterosexual women aged 15 to 49 with no prior births in the U.S., about 1 in 15 (19%) are unable to get pregnant after one year of trying (infertility), according to the CDC. (chiroeco.com)
  • infertility affected 43.8% of women. (bvsalud.org)
  • polymorphisms in infertile women with polycystic ovary syndrome or unexplained infertility. (cdc.gov)
  • Dysmenorrhea can occur without an underlying problem. (wikipedia.org)
  • This is because dysmenorrhea is often associated with changes in hormonal levels in the body that occur with ovulation. (wikipedia.org)
  • Primary dysmenorrhea is a form of the disorder that typically occurs within three years of your first menstrual period, though it can occur sooner. (fibromyalgia-symptoms.org)
  • The menstrual cycle is the scientific term for the physiological changes that can occur in fertile women for the purpose of sexual reproduction. (absoluteastronomy.com)
  • Fibroids usually occur in women in their 30s and 40s, although they can appear at any age. (whattoexpect.com)
  • Globally, 210 million women become pregnant each year, and 130 million births occur. (cdc.gov)
  • Many women also have a headache, nausea (sometimes with vomiting), and constipation or diarrhea. (msdmanuals.com)
  • Mean cortisol was significantly lower in women with dysmenorrhoea and was negatively correlated with the duration of the symptom. (ox.ac.uk)
  • The focus of discussion at remote consultation is different depending on whether the woman is using hormonal contraception. (pulsetoday.co.uk)
  • In this case, the woman should also have a pregnancy test even if she believes she couldn't be pregnant because she has had a recent bleed or uses contraception. (pulsetoday.co.uk)
  • In the United States, 12% of women who use contraception use IUDs. (msdmanuals.com)
  • Healthy women aged between 18 and 35 years (inclusive) in need of contraception. (who.int)
  • Primary dysmenorrhea is caused by a chemical imbalance due to the body producing too much of a hormone called prostaglandin, which makes the uterus contract in order to shed its lining. (nortonhealthcare.com)
  • Smoking, surgical removal of ovaries and uterus, chemotherapy and ethnicity can all impact the age at which women experience menopause, which comes with a multitude of potential symptoms. (chiroeco.com)
  • Primary dysmenorrhea is due to the secretion of prostaglandin (PG) F2a in the lining of the uterus. (studentnow.com)
  • The goal of treatment of primary dysmenorrhea is the minimization of discomfort and preservation of fertility. (studentnow.com)
  • Several complementary and alternative therapies have been utilized in the management of the discomfort of dysmenorrhea, although there are few or no studies to support their effectiveness or safety. (studentnow.com)
  • It is caused by increased endometrial of the eastern and western zones (the num- prostaglandin production and almost al- ber of schools is similar in each zone) as ways first occurs in women younger than well as 1 school from the rural sector. (who.int)
  • Endometrial inflammation factors play a crucial role in the common pathophysiology of primary dysmenorrhea. (pbbmi.org)
  • This is the leading cause of death (1 in 5 deaths) for black and white women in the United States, according to the Centers for Disease Control and Prevention (CDC). (chiroeco.com)
  • Where are the leading hospitals and centers of research for dysmenorrhea? (studentnow.com)
  • More than 10 million American women have this condition, estimates the Centers for Disease Control and Prevention. (healthline.com)
  • Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life. (wikipedia.org)
  • Approval of the lo- dysmenorrhoea occurs in the absence of cal directorate of education was obtained. (who.int)
  • For most females, it occurs between the ages of 9-15 , with the average age being 12.4 years. (medicalnewstoday.com)
  • IMB occurs in 20% of women in the first three months of starting the combined oral contraceptive pill (COCP) and in 30% with the progesterone-only pill, and some form of initial irregularity occurs in most women with the contraceptive implant or levonorgestrel-releasing intrauterine device, so it does not require further assessment unless it's prolonged or there are red flag symptoms (see part 1 of this series). (pulsetoday.co.uk)
  • PMS affects as many as 3 in 4 women , according to WomensHealth.gov. (healthline.com)
  • It is estimated that the disease affects 6 to 10% of women of reproductive age and more than 50% of infertile women. (bvsalud.org)
  • Many women experience relief from menstrual cramps just by switching to healthier nutritional habits. (alive.com)
  • Exercise and primary dysmenorrhoea. (studentnow.com)
  • This study aimed to determine the effectiveness of Slow Stroke Back Massage combined with Core Strengthening Exercise in reducing dysmenorrhea. (risetpress.com)
  • Primary dysmenorrhea is best treated with adequate rest and sleep, as well as exercise. (gynob.com)
  • Dysmenorrhea, or painful menses, is one of the most common gynecological complaints in young women, thought to affect 50% of all menstruating women. (studentnow.com)
  • Menstrual cramps seem to be part and parcel of the experience of menses for more than 50% of women. (gynob.com)
  • For women who are not using hormonal contraceptive, midcycle (periovulatory) IMB is usually physiological. (pulsetoday.co.uk)
  • About 1 in 4 (26%) women in this group have difficulty getting pregnant or carrying a pregnancy to term (impaired fecundity). (chiroeco.com)
  • It is important to remember that the risks and benefits must be weighed for each woman individually and that in most cases, pregnancy is more dangerous than pill use. (contemporaryobgyn.net)
  • This is where some women develop a glucose intolerance during pregnancy. (planetherbs.com)
  • Symptoms tend to lessen after women have their first pregnancy and as they get older. (msdmanuals.com)
  • In the African Region, many women are subjected to sociocultural discrimination as well as harmful traditional practices (HTPs) such as female genital mutilation4 (FGM), food taboos, early and forced marriage and pregnancy. (who.int)
  • According to the National Survey of Family Growth conducted in 2015-2017, 80.5% of reproductive-aged women who had ever been sexually active had used oral contraceptive pills (OCPs) at some point. (contemporaryobgyn.net)
  • Statistical analysis revealed significant associations between high or moderate stress levels, history of spontaneous abortion, and manufacturing workers and the presence of dysmenorrhea. (cdc.gov)