American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication type is effective for primary dysmenorrhea symptoms?

1. Antihistamines

2. NSAIDs

3. Beta-blockers

4. Opioids

The correct answer is: NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for managing primary dysmenorrhea symptoms because they directly target the underlying pain and inflammation associated with menstrual cramps. NSAIDs work by inhibiting the production of prostaglandins, which are hormone-like substances that contribute to uterine contractions and are responsible for causing the pain felt during menstruation. This reduction in prostaglandin levels leads to decreased menstrual pain and cramping, making NSAIDs a first-line treatment option for primary dysmenorrhea. Other medication types have different primary indications and do not specifically address the inflammatory process or the pain associated with primary dysmenorrhea. Antihistamines are typically used for allergic reactions and do not have a role in alleviating menstrual pain. Beta-blockers are primarily used for cardiovascular issues and anxiety-related symptoms, and while they might help with secondary complications like menstrual migraines, they are not effective for dysmenorrhea itself. Opioids are generally reserved for more severe pain management situations and carry a risk of dependence and side effects, making them less favorable for routine treatment of primary dysmenorrhea. Therefore, NSAIDs represent the most appropriate choice for symptomatic relief in this context.