Primary dysmenorrhea and secondary dysmenorrhea induced by an intrauterine device are associated with increased production and release of endometrial prostaglandins. The condition may be treated by oral contraceptives, which reduce overall menstrual fluid volume, or by a prostaglandin synthetase inhibitor, such as ibuprofen. Unless the patient wishes to use oral contraceptives for birth control, ibuprofen (Motrin) is the drug of choice because it need only be given for two to three days each cycle, does not suppress the pituitary ovarian axis, and does not cause metabolic alterations. Clinical trials have shown ibuprofen to be highly efficacious, and more effective than indomethacin, aspirin, or propoxyphene, with no or few side effects.