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Contraceptive Pearl: Contraception and Dysmenorrhea

Dysmenorrhea causes distress and missed days of school/work for millions of people. What’s the best way to treat it?

All hormonal contraceptives can help. The pill, patch, ring, implant, injection, and progestin IUD have evidence for benefit. Continuous use of the pill/patch/ring may provide extra help. The copper IUD, on the other hand, may worsen cramps.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are another mainstay of dysmenorrhea treatment.

Lifestyle measures can help, too. There is evidence for benefit from heating pads and exercise. Heat may work better than over-the-counter pain medications. There is weak evidence for benefit from some dietary supplements; these need more study.

Clinicians should ask patients about dysmenorrhea and offer lifestyle measures, hormonal contraceptives, and NSAIDS as treatment options.



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Armour M, Ee CC, Naidoo D, Ayati Z, Chalmers KJ, Steel KA, de Manincor MJ, Delshad E. Exercise for dysmenorrhoea. Cochrane Database Syst Rev. 2019 Sep 20;9(9):CD004142. doi: 10.1002/14651858.CD004142.pub4.

Osayande AS, Mehulic S. Diagnosis and initial managment of dysmenorrhea. Am Fam Physician. 2014 Mar 1;89(5):341-6. PMID: 24695505. 

Pattanittum P, Kunyanone N, Brown J, Sangkomkamhang US, Barnes J, Seyfoddin V, Marjoribanks J. Dietary supplements for dysmenorrhoea. Cochrane Database Syste Rev. 2016 Mar 22; 3(3): CD002124. doi: 10.1002/14651858.CD002124.pub2. 



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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