Congestive dysmenorrhea is seen in patients with-

Ans. is 'd' i.e., All the above Dvsmenorrhoea is described under three clinical varietieso Spasmodic dysmenorrhoea is the most prevalent and manifests as cramping pains, generally most pro- nounced on the first and second day of menstruation.o Congestive dysmenorrhoea manifests as increasing pelvic discomfort and pelvic pain a few days before menses begin. Thereafter, the patient rapidly experiences relief in the symptoms. This variety is commonly seen in PID, IUCD wearers, pelvic endometriosis and fibroids. It is also experienced by women having varicosity of pelvic veins.o Membranous dysmenorrhoea is a special group in which the endometrium is shed as a cast at the time of menstruation. The passage of the cast is accompanied by painful uterine cramps. This is a rare variety.