Dealing with Primary Dysmenorrhea

Which of the following is considered first-line therapy for primary dysmenorrhea?
A) Nonsteroidal anti-inflammatories (NSAIDs)
B) Selective serotonin receptor inhibitors (SSRIs)
C) Antiestrogens
D) Acupuncture
E) Tricyclic antidepressants





Answer and Discussion
Primary dysmenorrhea is associated with cramping pain in the lower abdomen occurring just before and/or during menstruation, in the absence of other conditions such as endometriosis. The initial presentation of primary dysmenorrhea typically occurs in adolescence.
The condition is associated with increased production of endometrial prostaglandin, resulting in increased uterine tone and stronger, more frequent uterine contractions. A diagnostic evaluation is unnecessary in women with typical symptoms and in the absence of risk factors for secondary causes.

NSAIDs are the most effective treatment, with the addition of oral contraceptive pills when necessary. About 10% of affected women do not respond to these measures. In these cases it is important to consider secondary causes of dysmenorrhea in women affected. Acupuncture is also used as an alternative treatment.The answer is A.