DYSMENORRHEA: CLINICAL MANIFESTATIONS, PATHOGENESIS AND CONTEMPORARY TREATMENT STRATEGIES

Dysmenorrhea is one of the most frequent gynecological complaints among adolescents and women of reproductive age. It is often normalized as a routine part of menstruation, yet recurrent menstrual pain may substantially reduce educational participation, work productivity, sleep quality, mental well-being, and social functioning. This article provides an IMRAD-based analytical review of dysmenorrhea with emphasis on clinical phenotypes, prostaglandin-centered pathogenesis, differential diagnosis, contemporary treatment strategies, real-world evidence, artificial intelligence, pharmacovigilance, and implementation perspectives for Uzbekistan. Evidence was synthesized from PubMed-indexed reviews, Cochrane evidence, WHO menstrual health materials, ACOG and ESHRE guidance, and regulatory sources from FDA and EMA on real-world evidence and AI-enabled health technologies. The review highlights that primary dysmenorrhea is mainly driven by increased endometrial production of prostaglandin F2α and prostaglandin E2, which induce myometrial hypercontractility, vasoconstriction, ischemia, and pain. Secondary dysmenorrhea requires active evaluation for endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, and structural anomalies. NSAIDs, hormonal therapy, heat therapy, exercise, patient education, and timely referral form the core of modern management. The article argues that modern dysmenorrhea care should combine pathophysiological reasoning with real-world evidence, patient-reported outcomes, pharmacovigilance, and ethically governed artificial intelligence. Such an approach is especially important for health systems developing electronic prescriptions, registries, and digital clinical decision support. For Uzbekistan, structured menstrual health documentation may create a foundation for safer analgesic use, earlier detection of secondary dysmenorrhea, and locally relevant research.