Primary dysmenorrhea in adolescents is best explained by, and first-line pharmacological treatment targets, which mediator?
- A Histamine, treated with antihistamines started after menses begin
- B Bradykinin, treated with corticosteroids started mid-cycle
- C Prostaglandins, treated with NSAIDs started just before or at onset of menses ✓
- D Serotonin, treated with SSRIs taken continuously
Correct answer: C. Prostaglandins, treated with NSAIDs started just before or at onset of menses
Explanation
Primary dysmenorrhea results from excessive endometrial prostaglandin F2 alpha and E2 release causing uterine hypercontractility and ischemic pain in ovulatory cycles. NSAIDs inhibit cyclooxygenase and are first line; they should be started just before or at the onset of flow and continued 2 to 3 days for maximal effect. Combined hormonal contraceptives are second line. Timing matters, since treating only after pain peaks yields inferior relief.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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