Which option would NOT be appropriate for the treatment of primary dysmenorrhea in an 18-year-old woman?

• A. Nonsteroidal anti-inflammatory medications
• B. Oral contraceptives
• C. Vitamin B6
• D. Intrauterine devices

Answer: (D)

In the context of managing primary dysmenorrhea, the treatment options typically focus on alleviating the pain associated with menstruation. Nonsteroidal anti-inflammatory medications (NSAIDs) and oral contraceptives are commonly used because they directly address the underlying mechanisms that contribute to menstrual pain, such as prostaglandin release and uterine contractions.

Although vitamin B6 has some anecdotal support for treating mild PMS symptoms, its efficacy in treating primary dysmenorrhea specifically is not well established and does not provide a direct approach to pain relief. Hence, while it may offer some benefit, it is not a standard treatment for this condition.

On the other hand, intrauterine devices (IUDs) are typically not appropriate as a first-line treatment for primary dysmenorrhea in young women, particularly if they have not previously undergone pregnancy. IUDs, especially hormonal types, are more appropriate for women who have already had children or for contraception management. Additionally, their insertion can be uncomfortable and may not be well tolerated by adolescents who are experiencing painful menstrual periods.

In summary, the use of an IUD for the treatment of primary dysmenorrhea is generally not considered suitable, especially in an 18-year-old woman who may