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Dysmenorrhea is defined as:

  1. Absence of menstruation

  2. Heavy menstrual bleeding

  3. Irregular menstruation

  4. Painful menstruation

The correct answer is: Painful menstruation

Dysmenorrhea is indeed defined as painful menstruation. This condition can result in significant discomfort or pain, which often occurs just before or during the menstrual period. It can be classified into two types: primary dysmenorrhea, which is typically linked to the menstrual cycle itself and is linked to the release of prostaglandins that cause uterine contractions, and secondary dysmenorrhea, which is generally due to underlying reproductive health issues like endometriosis or fibroids. In contrast, the other definitions provided relate to different menstrual issues. The absence of menstruation is known as amenorrhea, heavy menstrual bleeding is referred to as menorrhagia, and irregular menstruation can encompass a variety of menstrual disorders but is not specifically identified as dysmenorrhea. Thus, the definition of dysmenorrhea focuses uniquely on the aspect of pain associated with menstruation.