An 18-year-old college student who has recently become sexually active is seen for severe primary dysmenorrhea. She does not want to get pregnant, and has failed to obtain resolution with heating pads and mild analgesics. Which of the following medications is most appropriate for this patient?

Conservative measures for treating dysmenorrhea include heating pads, mild analgesics, sedatives or antispasmodic drugs, and outdoor exercise. In patients with dysmenorrhea there is a significantly higher than normal concentration of prostaglandins in the endometrium and menstrual fluid. Prostaglandin synthase inhibitors such as indomethacin, naproxen, ibuprofen, and mefenamic acid are very effective in these patients. However, for patients with dysmenorrhea who are sexually active, oral contraceptives will provide needed protection from unwanted pregnancy and generally alleviate the dysmenorrhea. The OCPs minimize endometrial prostaglandin production during the concurrent administration of estrogen and progestin.