Which of the following is a cause of dysmenorrhea:

Ans. is 'd' i.e., All of the above o Dysmenorrhea can be of two types:1. Spasmodic dysmenorrhea: Most prevalent, manifests as cramping pains, most pronounced on first and second day of menses.2. Congestive dysmenorrhea: Increasing pelvic discomfort and pelvic pain a few days before menses begin.o Dysmenorrhea is seen in the following conditions:# Fibroids, Endometrioisis and adenomyosis.# Adenomyosis is typically associated with triple dysmenorrhea, i.e., dysmenorrhea in premenstrual, menstrual and postmenstrual phases of the cycle.# In fibroid, both spasmodic and congestive dysmenorrhea may be seen. Spasmodic dysmenorrhea is possible when a submucous tumor stimulates expulsive uterine contractions.# Congestive dysmenorrhea may occur because of the associated pelvic congestion.o Causes of unilateral dysmenorrhea :# One horn of malformed uterus# Endometriosis with unilateral distribution# Small fibroid at the utero - tubal junction.# Ovarian dysmenorrhea# Right ovarian vein syndrome# Colonic or caecal spasm.