Which treatment is indicated for managing primary dysmenorrhea?

In managing primary dysmenorrhea, nonsteroidal anti-inflammatory drugs (NSAIDs) are considered the first-line treatment option. Primary dysmenorrhea is characterized by painful menstrual cramps without any identifiable pelvic pathology, and it is thought to be related to increased levels of prostaglandins, which are compounds that promote uterine contractions and lead to pain.

NSAIDs work by inhibiting the cyclooxygenase enzymes (COX-1 and COX-2) involved in the production of prostaglandins, thereby reducing their levels and subsequently decreasing the uterine contractions and pain associated with dysmenorrhea. They are effective in providing relief during menstrual cramps, making them a preferred choice for this condition.

Other treatments listed, such as hormone replacement therapy, antidepressants, and surgery, may be applicable in different contexts or specific cases of dysmenorrhea but are not standard first-line approaches for primary dysmenorrhea. Hormone replacement therapy might be used in cases related to hormonal imbalances but is not specifically indicated for primary dysmenorrhea. Antidepressants can help manage pain and mood symptoms in certain chronic pain conditions but are not conventional treatment for primary dysmenorrhea itself. Surgery is generally reserved for cases where