What is the first-line treatment for primary dysmenorrhea?

• A. Hormonal therapy
• B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
• C. Antidepressants
• D. Oral contraceptives

Answer: (B)

The first-line treatment for primary dysmenorrhea is nonsteroidal anti-inflammatory drugs (NSAIDs) because they effectively reduce the pain associated with this condition. NSAIDs, such as ibuprofen or naproxen, work by inhibiting the production of prostaglandins, which are chemicals that promote uterine contractions and contribute to menstrual pain. By reducing prostaglandin levels, NSAIDs help alleviate cramps and discomfort during menstruation.

While hormonal therapy and oral contraceptives are also used to manage menstrual pain by regulating hormones and potentially reducing menstrual flow and cramps, they are generally considered second-line options. Hormonal treatments are typically prescribed for women who have not found relief with NSAIDs or those who have additional symptoms that might benefit from hormonal regulation.

Antidepressants are not typically used as a first-line treatment for primary dysmenorrhea, as their primary indication is for mood disorders and not for the management of menstrual pain specifically. Thus, NSAIDs remain the most immediate and effective choice for treating the pain associated with primary dysmenorrhea.