What is a common finding in patients with primary dysmenorrhea during a pelvic exam?

In patients with primary dysmenorrhea, the pelvic exam typically reveals normal findings, particularly during the bimanual examination. Primary dysmenorrhea is characterized by pain that results from the release of prostaglandins during menstruation, which causes increased uterine contractions without any underlying pathological condition. Therefore, the uterus and surrounding structures usually appear normal upon examination, and the absence of significant findings, such as adnexal tenderness, cervical motion tenderness, or uterine enlargement, supports the diagnosis of primary dysmenorrhea rather than secondary dysmenorrhea or other pelvic conditions.

Normal bimanual exams indicate that there are no structural issues or inflammatory changes, which is a key characteristic distinguishing primary dysmenorrhea from other types of dysmenorrhea that may present with additional clinical findings.