This gene encodes a protein essential for the regulation of immunity and inflammation.15 While the mechanism of how it influences PD has yet to be discovered, it is assumed that possible mutations in IL1A or genes which interact with it impact the regulation of inflammation during menstruation. These mutations may therefore affect pain responses during menstruation which lead to the differing phenotypes associated with dysmenorrhea. Two additionally well studied SNPs which are suspected to contribute to PD were found in ZM1Z1 (the mutant allele called rs76518691) and NGF (the mutant allele called rs7523831). Both ZMIZ1 and NGF are associated with autoimmune responses and diseases, as well as pain response. The implication of these genes impacting Dysmenorrhea is significant as it suggests mutations which affect the immune system (specifically the inflammatory response) and pain response may also be a cause of primary dysmenorrhea. Mechanism
The underlying mechanism of primary dysmenorrhea is the contractions of the muscles of the uterus which induce a local ischemia.During an individuals menstrual cycle, the endometrium thickens in preparation for potential pregnancy. After ovulation, if the ovum is not fertilized and there is no pregnancy, the built-up uterine tissue is not needed and thus shed. Prostaglandins and leukotrienes are released during menstruation, due to the build up of omega-6 fatty acids. Release of prostaglandins and other inflammatory mediators in the uterus cause the uterus to contract and can result in systemic symptoms such as nausea, vomiting, bloating and headaches or migraines. Prostaglandins are thought to be a major factor in primary dysmenorrhea.
The vaginal vault is the expanded region of the vaginal canal at the internal end of the vagina. Prolapse
The vaginal vault may prolapse after a hysterectomy, as there is no uterus supporting the interior end of the vagina. Colposacropexy is often used for treating vaginal vault prolapse. A Cochrane Collaboration review[needs update] found that limited data are available on optimal surgical approaches, including the use of transvaginal surgical mesh devices, in the form of a patch or sling, similar to its implementation for abdominal hernia. However, the use of a transvaginal mesh in treating vaginal prolapses is associated with side effects including pain, infection, and organ perforation. According to the FDA, serious complications are "not rare." A number of class action lawsuits have been filed and settled against several manufacturers of TVM devices. See also
Vagina
Hysterectomy

References
External links
Dictionary definition of "Vaginal vault" from TheFreeDictionary.com