Long-Term Management and Prevention Strategies for Adolescent Primary Dysmenorrhea: From Precision Diagnosis to Comprehensive Intervention.

Adolescent primary dysmenorrhea (PD) is one of the most prevalent gynecological issues in adolescent females, and its long-term management and prevention are crucial for improving quality of life, preventing secondary complications, and safeguarding future reproductive health. This narrative review examines the pathophysiological mechanisms, key points of differential diagnosis, long-term pharmacological and non-pharmacological management strategies, lifestyle interventions, psychosocial support, and evidence-based prevention frameworks for adolescent PD. It particularly emphasizes the importance of accurately distinguishing rare organic conditions, such as Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome, which can mimic primary dysmenorrhea, during long-term management to avoid misdiagnosis and delayed treatment. This narrative review synthesizes current evidence on adolescent primary dysmenorrhea. Its primary objective is to provide clinicians with a comprehensive, staged, and individualized long-term management framework that integrates pharmacological, non-pharmacological, lifestyle, and psychosocial interventions, while emphasizing the importance of accurate differential diagnosis and patient empowerment through health education. Key outcome measures assessed in this review include pain severity, pain duration, quality of life, school absenteeism, medication use, and adverse effects.