What is the diagnosis and treatment for Primary Dysmenorrhea (Painful Menstruation)?

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From the FDA Drug Label

DOSAGE AND ADMINISTRATION ... Dysmenorrhea: For the treatment of dysmenorrhea, beginning with the earliest onset of such pain, ibuprofen tablets should be given in a dose of 400 mg every 4 hours as necessary for the relief of pain. The recommended dose of ibuprofen for the treatment of primary dysmenorrhea is 400 mg every 4 hours as necessary for relief of pain 1.

  • The dose should be taken at the earliest onset of pain.
  • Ibuprofen can be used to treat mild to moderate pain associated with dysmenorrhea.
  • The patient's dose should be reviewed and adjusted as required to achieve a satisfactory response.

From the Research

Primary dysmenorrhea should be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) as the first line of treatment, with the option of combined hormonal contraceptives for women who desire contraception, as supported by the most recent and highest quality study 2. The treatment of primary dysmenorrhea is crucial to improve the quality of life of women suffering from this condition.

  • The pathophysiology of primary dysmenorrhea involves the overproduction of prostaglandins by the endometrium, leading to uterine hypercontractility and pain 2.
  • NSAIDs, such as ibuprofen and naproxen, are effective in reducing prostaglandin synthesis and alleviating pain, as demonstrated in several studies, including a systematic review of 73 randomized controlled trials 3.
  • Combined hormonal contraceptives are also effective in reducing dysmenorrheic pain, particularly for women who desire contraception, by preventing ovulation and reducing endometrial growth, as shown in a review of 18 publications, including 10 randomized controlled trials and 6 nonrandomized observational or prospective studies 4.
  • Non-pharmacological approaches, such as heat therapy, regular exercise, and adequate sleep, may also be beneficial in reducing symptoms, although the evidence is less robust.
  • It is essential to note that the treatment of primary dysmenorrhea should be individualized, and women who do not respond to first-line treatment or have underlying medical conditions may require alternative approaches, as suggested by a study on the prophylactic administration of ibuprofen for severe and disabling primary dysmenorrhea 5.
  • The use of NSAIDs and hormonal contraceptives has been shown to be effective in reducing pain and improving quality of life, with the most recent and highest quality study supporting the use of these treatments as the first line of therapy 2.

References

Research

Primary Dysmenorrhea: Assessment and Treatment.

Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 2020

Research

Nonsteroidal anti-inflammatory drugs for dysmenorrhoea.

The Cochrane database of systematic reviews, 2010

Research

[Preventive treatment of primary dysmenorrhea with ibuprofen].

Ginecologia y obstetricia de Mexico, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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