What is the primary feature of primary dysmenorrhea?

The primary feature of primary dysmenorrhea is menstrual cramps that occur without any underlying pathology. This condition is characterized by cyclical abdominal pain associated with menstruation, which arises due to the increased production of prostaglandins that stimulate uterine contractions. These contractions can lead to significant discomfort or pain, typically beginning shortly before or during menstruation and often improving as the period progresses.

In contrast to primary dysmenorrhea, other options describe symptoms or conditions that are not characteristic of this diagnosis. Severe fatigue during menstruation could be related to other issues, such as anemia or hormonal changes, which are not specific to primary dysmenorrhea. Heavy menstrual bleeding may indicate a different underlying issue, such as fibroids or hormonal imbalances, while intermittent pelvic pain not related to menstruation could suggest a chronic pain condition or another gynecological issue unrelated to the menstrual cycle. Therefore, the hallmark of primary dysmenorrhea is the occurrence of menstrual cramps in the absence of identifiable pelvic pathology.