A comprehensive review and the pharmacologic management of primary dysmenorrhea

Article information

J Korean Med Assoc. 2020;63(3):171-177

Publication date (electronic) : 2020 March 17

doi : https://doi.org/10.5124/jkma.2020.63.3.171

¹Department of Obstetrics and Gynecology, Kyungpook National University Hospital, Daegu, Korea

²Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

Corresponding author: Seul Ki Kim E-mail: skkim@snubh.org

Revised 2020 January 21; Accepted 2020 February 06.

Abstract

Dysmenorrhea is the most common gynecologic condition in women during the reproductive period. Severe dysmenorrhea pain affects their social activities, sleep, and quality of life. Nevertheless, the proportion of women with dysmenorrhea do not receive adequate medical counseling or pharmacological treatments. Primary dysmenorrhea is diagnosed clinically, and the secondary causes that can cause pelvic pain should be identified. The treatment of choice for primary dysmenorrhea is non-steroidal anti-inflammatory drugs (NSAIDs). In order to maximize the therapeutic effect, it is necessary to ensure that the appropriate medication is administered in a proper way. NSAIDs can cause adverse effects, including gastrointestinal disorders. If side effects occur or are anticipated with NSAIDs, the use of hormonal contraceptives may be recommended when contraception is considered. In addition to these pharmacological treatments, heat, dietary, and behavioral therapies have been tried and reported to have some effects. However, further research is required for robust conclusions.

Keywords: Dysmenorrhea; Menstruation; Non-steroidal anti-inflammatory agents; Contraceptive agents

Figure 1.

Metabolic pathways of uterine contraction in dysmenorrhea. LT, leukotriene; PGG₂, prostaglandin G₂; PGH₂, prostaglandin H₂; PGF_2α, prostaglandin F_2α; PGE₂, prostaglandin E₂.

Figure 2.

Treatment options for dysmenorrhea. NSAIDs, non-steroidal antiinflammatory drugs.

Table 1.

Charact teristics of primary and secondary dysmenorrhea

Table 2.

Non-steroidal anti-inflammatory agents to treat dysmenorrhea

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