A 13-year-old female has lower mid-abdominal pain that starts within a few hours of menses onset. What is the most likely diagnosis?

A 13-year-old female has lower mid-abdominal pain that starts within a few hours of menses onset. What is the most likely diagnosis?

• A. Ovarian cyst
• B. Endometriosis
• C. Primary dysmenorrhea
• D. Premenstrual syndrome

Answer: (C)

The scenario describes a 13-year-old female experiencing lower mid-abdominal pain that begins within a few hours of the onset of her menses. The most likely diagnosis is primary dysmenorrhea, which is the most common cause of menstrual-related pelvic pain in adolescents. Primary dysmenorrhea is characterized by cramping pain in the lower abdomen that typically occurs just before or at the onset of menstruation. This condition is linked to increased prostaglandin production, leading to uterine contractions and consequently causing pain. It is important to note that primary dysmenorrhea is not associated with any underlying pelvic pathology, which makes it particularly common in this age group, especially for those who have recently begun menstruating. Understanding the age group and the nature of the pain (starting shortly after the menstrual onset) helps clarify why primary dysmenorrhea fits the case well. Other conditions, such as ovarian cysts or endometriosis, typically present with different patterns of pain or symptoms that may not align as closely with the timely onset following menstruation. In contrast, premenstrual syndrome (PMS) encompasses a range of emotional and physical symptoms that occur before the onset of menstruation and are not strictly characterized by the type of

The scenario describes a 13-year-old female experiencing lower mid-abdominal pain that begins within a few hours of the onset of her menses. The most likely diagnosis is primary dysmenorrhea, which is the most common cause of menstrual-related pelvic pain in adolescents.

Primary dysmenorrhea is characterized by cramping pain in the lower abdomen that typically occurs just before or at the onset of menstruation. This condition is linked to increased prostaglandin production, leading to uterine contractions and consequently causing pain. It is important to note that primary dysmenorrhea is not associated with any underlying pelvic pathology, which makes it particularly common in this age group, especially for those who have recently begun menstruating.

Understanding the age group and the nature of the pain (starting shortly after the menstrual onset) helps clarify why primary dysmenorrhea fits the case well. Other conditions, such as ovarian cysts or endometriosis, typically present with different patterns of pain or symptoms that may not align as closely with the timely onset following menstruation.

In contrast, premenstrual syndrome (PMS) encompasses a range of emotional and physical symptoms that occur before the onset of menstruation and are not strictly characterized by the type of