Presumed Primary Dysmenorrhea in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#556
SMLE Question #556
Obstetrics & Gynecology
General Gynecology
Last updated: February 2026
A 23-year-old nulliparous woman has severe crampy lower abdominal pain that starts a few hours before menses and continues through the first 1–2 days. Over the past year, symptoms have progressed and now cause her to miss work. Acetaminophen provides minimal relief. Pelvic examination between menses is normal, and a urine pregnancy test is negative. She prefers medical management for presumed primary dysmenorrhea. What is the best initial pharmacologic therapy?
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