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December 4, 1981

Antiprostaglandins for Primary Dysmenorrhea

Author Affiliations

Woodbury, NY

JAMA. 1981;246(22):2576-2577. doi:10.1001/jama.1981.03320220028015

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To the Editor.—  Primary dysmenorrhea is defined as painful menstruation characterized by the absence of clinical pelvic abnormality. It usually has its onset during the teenage years when menses become ovulatory. Primary dysmenorrhea is a major cause of lost workdays and school days around the world. Recent research has shown that the problem can be alleviated in most women by the administration of antiprostaglandin medications.Studies indicate that 80% to 85% of women respond to antiprostaglandin drug therapy. Women who fail to respond often are considered as not having a prostaglandin basis to their dysmenorrhea, or as having a psychological overlay. In my practice, however, I have found that, in these women, by switching to a second, third, or even fourth drug, more than 95% will respond. The basis for improvement with one antiprostaglandin medication, but not another, probably lies in individual chemical idiosyncracy. Another related phenomenon is the development