About
Dysmenorrhea

Dysmenorrhea, also known as menstrual pain, impacts 300 million women around the globe

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PREVALENCE & IMPACT

Although a common condition dysmenorrhea is not normal

Menstrual pain is a huge macroeconomic challenge. 300 million women aged 15-49 worldwide suffer from primary dysmenorrhea¹. It significantly impacts quality of life, productivity, and mental health.

OUR SOLUTION →
OUR SOLUTION →

$4,882 is the cost of lost productivity per person annually²

38% of patients report not being able to perform regular daily activities during menstruation³

62% of patients are unsatisfied with current pain management solutions⁴

1 in 6 women is contraindicated for hormonal therapy⁵

References:
1 de Arruda GT, Barbosa-Silva J, Driusso P, Pathmanathan C, Armijo-Olivo S, Avila MA. Pain. 2026;167(1):41-55 
2 O'Shea et al., Australian Journal of Social Issues, 2026. Figure reflects Australian survey data (Int$4,882/woman/year, PPP-adjusted). Meliodays’ estimate: comparable order-of-magnitude loss expected across Meliodays’ target market; 
3  Schoep, M. E., et al. (2019). "The impact of menstrual symptoms on everyday life: a survey among 42,879 women." Am J Obstet Gynecol 220(6): 569.e561–569.e567
4 Meliodays Period Pain Report, 2024 (N.800 women in the US and Germany) 
5  Erly SJ, Forward TR, Rogers ZH, Hawes SE, Micks E. J Womens Health (Larchmt). 2022;31(4):580-585, Lauring JR, Lehman EB, Deimling TA, Legro RS, Chuang CH. Am J Obstet Gynecol. 2016;215(3):330.e1-7

TYPES OF DYSMENORRHEA

Primary Dysmenorrhea

  • Menstrual pain occurring without any underlying structural pelvic pathology or organ-related gynecological condition

  • Recurrent, cramping lower abdominal and pelvic pain that peaks during the first 1–2 days of menstruation

Risk factors

  • Key risk factors include a family history of primary dysmenorrhea, early age of menarche, and heavy menstrual flow

  • Cannot be prevented, but individual pain and symptoms can be effectively managed

  • Highly prevalent among adolescents and young adults

Pathophysiology & Mechanism

  • Driven primarily by the hyperproduction of, or heightened sensitivity to, uterine inflammatory prostaglandins, predominantly PGE2 and PGF2α

  • Released during endometrial sloughing at menses, prostaglandins trigger contractions, reduced uterine blood flow, and temporary tissue ischemia

Clinical Onset & Course

  • Onset typically begins early, usually 6 to 24 months after menarche, once ovulatory cycles are established

  • Pain timing starts shortly before or at the onset of menses and sharply peaks during the first 24 to 48 hours

  • Symptoms often improve after childbirth or with advancing age

Symptoms

  • Pelvic & Abdominal Pain: Lower abdominal or pelvic cramping that begins shortly before or at the onset of menses and subsides as flow decreases

  • Systemic Symptoms: Headaches, body and joint aches, lethargy, fatigue, sleep disturbances, tender breasts, and swollen legs

  • Gastrointestinal Symptoms: Appetite changes, nausea, vomiting, bloating, and abdominal discomfort

  • Elimination & Autonomic Symptoms: Diarrhea, constipation, polyuria, and hyperperspiration (sweating)

  • Psychological Impact: Mood swings, heightened anxiety, irritability, and emotional strain during the premenstrual and early menstrual phase


Management & Therapy

  • First-line pharmacologic options include over-the-counter or prescription NSAIDs and hormonal contraceptives

  • Non-pharmacologic and lifestyle strategies include heat therapy, exercise, dietary adjustments, and acupuncture

  • Pain is generally responsive to standard first-line therapies

Secondary Dysmenorrhea

  • Menstrual pain caused by an underlying pelvic pathology or organ-related gynecological condition

  • Common causes include endometriosis, adenomyosis, uterine fibroids, pelvic inflammatory disease, and more

  • Pain can occur across the entire menstrual cycle and frequently persists during non-menstrual periods

Risk factors

  • Risk factors include prior pelvic infections, pelvic or uterine surgeries, and family history of gynecological conditions

  • Can affect individuals at any reproductive age, with risk increasing with the presence or progression of pelvic disease

  • Root resolution depends on identifying and treating the underlying disease state

Pathophysiology & Mechanism

  • Driven by structural lesions, tissue invasion, adhesions, and localized tissue inflammation

  • Structural changes further trigger elevated prostaglandin production, leading to severe uterine contractions and pain

  • Mechanical obstruction or altered pelvic anatomical alignment can also directly cause pain and pressure

Clinical Onset & Course

  • Symptom onset can begin during adolescence or years after menarche

  • Symptoms are often misattributed to primary dysmenorrhea, leading to significant diagnostic delays before the root condition is identified

  • Pain is progressive over time and often refractory or poorly responsive to standard over-the-counter NSAIDs

Symptoms

  • Pelvic & Abdominal Pain: Lower abdomen, pelvic, or lower back pain that often starts several days before menses and persists through or beyond the bleed; painful intercourse and persistent pelvic pressure

  • Gastrointestinal Symptoms: Severe bloating, painful bowel movements, diarrhea, or constipation, especially tied to menses

  • Urinary Symptoms: Painful urination, urinary frequency, or urgency when adjacent pelvic structures are involved

  • Reproductive & Cycle Irregularities: Heavy menstrual bleeding (menorrhagia), intermenstrual spotting, and subfertility or infertility

  • Systemic & Psychological Impact: Chronic fatigue, sleep disturbance, and emotional distress from prolonged, unmanaged pain



Management & Therapy

  • Requires clinical workup and evaluation, including pelvic imaging (e.g., ultrasound, MRI) and diagnostic laparoscopy

  • Medical strategies include targeted hormonal suppression, progestins, or GnRH agonists/antagonists

  • Surgical interventions are frequently utilized for both definitive diagnosis and treatment, e.g., laparoscopic excision, lesion ablation, or myomectomy

Frequently Asked Questions (FAQs)

  • Oral NSAIDs depend on correct timing, dosage, and adherence. Some patients see only partial relief or stop use due to gastrointestinal or cardiovascular side effects. 

  • Chronic systemic use of oral painkillers can increase the risks of gastric irritation, ulcers, and, in some cases, renal or cardiovascular effects, making safer, targeted approaches worth exploring. 

  • Medicine has long turned to hormones, usually via contraceptives, to suppress cycles and reduce pain. But not everyone can or wants to take hormones, and side effects often limit their use. 

  • Menstrual pain management options are limited to oral painkillers, hormone therapy, lifestyle adjustments, and non-pharmacologic options such as heat therapy, CBD tampons, and period supplements.

    There are few pharmacologic, long-acting, hormone-free treatments on the market. That’s precisely why we’re building a non-hormonal, long-term solution like MelioOne®