Primary dysmenorrhea

• Facts:
  Severe uterine pain during menstruation
  
  Pain caused by the release of prostaglandins during the breakdown of the endometrium
• History / PE:
  Lower abdominal pain that radiates to the thighs and back and begins hours before menstruation
• Diagnosis:
  Elevated prostaglandin levels
• Treatment:
  NSAIDs and OCPs
• Differential Diagnosis:
  Endometriosis (dysmenorrhea, dyspareunia, infertility)
  Ectopic pregnancy