What is the first-line treatment for painful periods due to secondary dysmenorrhea?

The first-line treatment for painful periods associated with secondary dysmenorrhea is nonsteroidal anti-inflammatory drugs (NSAIDs). Secondary dysmenorrhea usually arises from an underlying condition, such as endometriosis, fibroids, or pelvic inflammatory disease, and is characterized by pain due to these pathologies.

NSAIDs work effectively by inhibiting the production of prostaglandins, which are compounds involved in inflammation and pain. By reducing the levels of these substances in the body, NSAIDs can alleviate menstrual-related pain significantly. This class of medications is generally preferred due to their safety profile, availability, and rapid onset of action, making them suitable for managing acute pain during menstruation.

While oral contraceptives can also be beneficial in managing secondary dysmenorrhea, particularly in cases involving hormonal imbalances or conditions like endometriosis, they are not considered first-line in all cases due to the time required for their effects to become evident and the fact that they may not address the immediate pain experienced during menstruation.

Antibiotics are typically indicated for infections but do not treat the underlying pain associated with dysmenorrhea itself. Similarly, exercise and physical therapies can provide overall health benefits and may aid in some cases, but