Refractory Dysmenorrhea Managed With a Glucagon-Like Peptide-1 Agonist: A Case Report

Dysmenorrhea includes symptoms such as abdominal pain, nausea, and vomiting. It is a clinical diagnosis with typical treatment involving the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapy. Even with conventional treatment, many women deal with dysmenorrhea refractory to treatment. They are often subject to dealing with the adverse effects of those treatments, such as peptic ulcer disease. We present a case of a patient with severe refractory dysmenorrhea who was able to minimize symptoms with the use of semaglutide, a glucagon-like peptide-1 (GLP-1) agonist. With no changes in the patient's lifestyle and no additional medications added, the semaglutide therapy was able to minimize the patient's symptoms to where she was able to continue activities of daily living and minimize the use of NSAID therapy. Moreover, the patient experienced no changes in weight and only transient loss of appetite while on semaglutide. We hypothesize that anti-estrogenic and anti-inflammatory properties are potential mechanisms of action in this case. This case brings to light the possible multifaceted applications of GLP-1 agonists beyond weight control and diabetes. The outcome of this case suggests that a controlled trial of GLP-1 agonist therapy is warranted to determine its potential for the management of dysmenorrhea.