What is the most effective treatment for primary dysmenorrhea?

The most effective treatment for primary dysmenorrhea is prostaglandin inhibitors. Primary dysmenorrhea is characterized by painful menstrual cramps that are typically caused by the release of prostaglandins, which are hormone-like substances involved in inflammation and pain. During menstruation, elevated levels of prostaglandins lead to increased uterine contractions, resulting in discomfort and pain.

Prostaglandin inhibitors, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, effectively reduce the production of prostaglandins by blocking the enzyme cyclooxygenase (COX). This reduction in prostaglandin levels lessens the intensity of uterine contractions and thus alleviates pain. This mechanism makes prostaglandin inhibitors particularly effective for managing the cramping associated with primary dysmenorrhea.

Other treatments listed, such as tricyclic antidepressants, GnRH agonists, and dopamine agonists, are not primarily aimed at addressing the underlying cause of primary dysmenorrhea—excessive prostaglandin release—and are typically used in different contexts. Tricyclic antidepressants may be effective for some chronic pain conditions but are not frontline treatments for dysmenorrhea. GnRH