Which of the following is a potential cause of secondary dysmenorrhea?

• A. Hormonal fluctuations
• B. Uterine fibroids
• C. Menstrual cycle irregularities
• D. Emotional stress

Answer: (B)

Secondary dysmenorrhea refers to menstrual pain that is associated with an underlying reproductive health condition rather than just the normal physiological processes of menstruation. Uterine fibroids, which are noncancerous growths in the uterus, can lead to significant changes in the uterine environment, potentially increasing menstrual cramping and associated pain. As these fibroids grow, they may distort the uterus and cause heavier menstrual bleeding and increased pressure and pain during menstruation.

The other options may affect menstrual health or experience in a general sense but do not directly lead to secondary dysmenorrhea. Hormonal fluctuations can contribute to primary dysmenorrhea by causing changes in the endometrium, but they are not a direct cause of secondary dysmenorrhea. Menstrual cycle irregularities can result in pain but are considered more closely related to primary dysmenorrhea due to their non-pathological nature. Emotional stress may exacerbate the perception of pain but doesn't directly cause structural issues like uterine fibroids do. Therefore, uterine fibroids provide a clear link to secondary dysmenorrhea through their direct impact on the uterus and menstrual function.