In the absence of any significant findings, how should primary dysmenorrhea be managed?

Primary dysmenorrhea, which is defined as menstrual pain not associated with an underlying pelvic pathology, is commonly managed effectively with nonsteroidal anti-inflammatory drugs (NSAIDs). The rationale for using NSAIDs is based on their ability to inhibit the synthesis of prostaglandins, which are compounds in the body that promote uterine contractions and are closely associated with menstrual pain. By reducing the production of prostaglandins, NSAIDs can alleviate cramping and discomfort experienced during menstruation.

While hormonal therapy and oral contraceptives are also recognized methods for managing symptoms of dysmenorrhea, particularly in cases where hormonal regulation may be beneficial, they may not be the first-line treatment in the absence of significant findings. Lifestyle changes, although helpful in supporting overall well-being, typically have a more limited effect on the acute symptoms of dysmenorrhea compared to the direct analgesic action of NSAIDs. Thus, NSAIDs remain the most established, immediate, and effective approach to relieve the pain associated with primary dysmenorrhea in patients who do not have underlying conditions necessitating other forms of intervention.