A 15-year-old female presents for evaluation for painful menstrual cycle. She has a history of migraines with aura.

    May 5, 2024

A 15-year-old female presents for evaluation for painful menstrual cycle. She has a history of migraines with aura. She had her first menstrual cycle at the age of 12 years. Over the last few years, each period has lasted 6-7 days and occurs once every 29 days. Over the last 6 months, she has experienced pain in her lower abdominal and upper thighs during the first few days of her menstrual cycle. She has missed 2-3 days of school each month due to the pain. She denies sexual activity. She has not tried any over the counter medications for the pain. Which of the following would be the first-line treatment for her condition? A. Norgestrel 0.3mg/ethinyl estradiol 30ug Q day for 30 days B. Transdermal patch containing 6 mg norelgestromin and 75mg EE C. Acetaminophen 500mg Q4-6 hours D. Naproxen 500mg once, then 250 mg Q6-8 hours

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