Approach to treatment of primary dysmenorrhea in adult women

NSAID: nonsteroidal anti-inflammatory drug; IUD: intrauterine device; DMPA: depot medroxyprogesterone acetate.
* For information on the diagnosis and evaluation of pelvic pain in women, refer to related UpToDate content on pelvic pain and dysmenorrhea.
¶ Discussion of NSAID indications and adverse effects is presented in related UpToDate content.
Δ The choice of contraceptive method is ultimately determined by the patient and based upon her preferences for contraceptive efficacy, adverse effects, dosing, cycle control, cost, and availability, among other variables.
◊ Oral medroxyprogesterone acetate and norethindrone acetate are not labeled for contraception. Thus, patients desiring contraception should be counseled to use an additional contraceptive method.