What is the first-line pharmacological treatment for moderate to severe menstrual pain?

• A. Opioids
• B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
• C. Oral contraceptives
• D. Acetaminophen

Answer: (B)

The first-line pharmacological treatment for moderate to severe menstrual pain, known as dysmenorrhea, is nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen or naproxen, work by inhibiting the production of prostaglandins, which are chemicals in the body that promote inflammation and are largely responsible for the cramping and pain experienced during menstruation. By reducing the levels of these prostaglandins, NSAIDs effectively alleviate pain and discomfort.

While other options like opioids can be effective for severe pain, they are typically reserved for situations where NSAIDs are ineffective or contraindicated due to their potential for dependency and side effects. Oral contraceptives can also help manage menstrual pain by regulating hormones and reducing endometrial tissue buildup, but they are often considered a secondary option, especially when immediate pain relief is needed. Acetaminophen, though useful for pain relief, does not address the underlying inflammatory processes as effectively as NSAIDs do, making it less favorable for treating dysmenorrhea specifically.

Therefore, the efficacy of NSAIDs in directly targeting the underlying cause of menstrual pain and their well-established role as the first-line treatment makes them the optimal choice for women experiencing moderate to severe menstrual pain