Treatment of primary dysmenorrhea

The management of primary dysmenorrhea is discussed, firstly from the viewpoint of the adolescent girl and secondly of the adult woman. Sexually active girls wishing to use contraceptive agents are recommended low-dose oral contraceptives (OC). Teenagers with severe dysmenorrhea who do not require OC are prescribed a prostaglandin synthetase inhibitor. The adult woman has first the choice between OC and prostaglandin synthetase inhibitor as well. When all these are ineffective, secondary causes of dysmenorrhea must be sought and specific treatment eventually required. When no medication affords pain relief, however, and no organic cause can be found, the patient is referred for pain consultation. Hysterectomy is discussed as the final solution for the elderly woman.