THE ROLE OF PROSTAGLANDINS IN PRIMARY DYSMENORRHEA AND THE EFFECTIVENESS OF ANTI-INFLAMMATORY THERAPY

Primary dysmenorrhea is a recurrent menstrual pain syndrome occurring in the absence ofidentifiable pelvic pathology. Its most accepted pathophysiological model centers on increasedendometrial production of prostaglandin F2α and prostaglandin E2 during menstruation. Thesemediators intensify uterine contractions, increase intrauterine pressure, reduce uterine blood flow,induce ischemia, and sensitize pain pathways. This article reviews the biological role ofprostaglandins, the clinical rationale for NSAID therapy, timing and safety considerations, realworldeffectiveness, pharmacovigilance, artificial intelligence, and personalized treatment strategies.The evidence synthesis shows that anti-inflammatory therapy is pathogenetically justified whenprimary dysmenorrhea is prostaglandin-dominant. However, treatment success depends on earlyinitiation, correct dosing, patient education, safety screening, and reassessment when response isinadequate. Real-world data and AI-based analytics may help identify patients with poor response,detect adverse drug reaction signals, and improve clinical decision support. The article alsodiscusses how Uzbekistan’s developing e-prescription and digital health systems may support saferNSAID use and national evidence generation
complete clinical strategy that includes diagnosis, timing, adherence, contraindication screening,follow-up, and referral criteria. When this strategy is implemented correctly, prostaglandininhibition remains a rational first-line approach. When it fails, clinicians should consider secondarydysmenorrhea, central sensitization, inadequate exposure, or non-prostaglandin mechanisms ratherthan repeating empirical analgesic escalation