Dysmenorrhoea (Primary)

Management

• Provide full explanation and appropriate reassurance

• Promote a healthy lifestyle: regular exercise; avoid smoking and excessive alcohol

• Recommend relaxation techniques such as yoga

• Avoid exposure to extreme cold

• Place a heat pack over the painful area and curl the knees onto the chest

Medication

Options include (trying in order):

• simple analgesics (e.g. aspirin or paracetamol)

• prostaglandin inhibitors (e.g. mefenamic acid, 500 mg tds)

• NSAIDs (e.g. naproxen, 500 mg statim then 250 mg tds or ibuprofen) in the first 3 d of the period

• combined oral contraceptive pill

• if above treatments are ineffective, further investigation is required for secondary causes (e.g. endometriosis)