What is considered the first-line treatment for primary dysmenorrhea?

The first-line treatment for primary dysmenorrhea is nonsteroidal anti-inflammatory drugs (NSAIDs). This is because primary dysmenorrhea is primarily caused by the release of prostaglandins, which lead to uterine contractions and pain. NSAIDs work by inhibiting the production of these prostaglandins, thereby reducing inflammation and alleviating pain. They are effective for managing the symptoms of dysmenorrhea and can be taken at the onset of pain or in anticipation of menstrual discomfort.

While oral contraceptives can be effective in managing menstrual pain and regulate menstrual cycles over time, they are generally considered a secondary option, particularly for those seeking ongoing relief rather than immediate symptom management. Similarly, acetaminophen may provide some relief for mild pain but is not as effective as NSAIDs for dysmenorrhea, especially in moderate to severe cases. Dietary changes, while potentially beneficial for overall health, do not directly address the underlying pain mechanisms associated with dysmenorrhea. Thus, NSAIDs are the preferred option for their targeted action and effectiveness in treating the acute symptoms of primary dysmenorrhea.