NSAID Use for Treating Dysmenorrhea and Preventing Chronic Pelvic Pain

Inclusion Criteria:

• aged 18-35

• individuals who menstruate, with painful periods

• regular menstrual cycles (every 22-35 days)

Exclusion Criteria:

• presence of active pelvic or abdominal malignancies (primary or metastatic)

• conditions associated with the absence of regular menses such as polycystic ovariansyndrome, pregnancy, or any current use of continuous hormonal medication orcontraceptive

• unable to read or comprehend the informed consent in English

• presence of other diagnosed chronic back or pelvic pain conditions (includingchronic back pain, fibromyalgia, bladder pain syndrome, irritable bowel syndrome,vulvar pain syndrome, and endometriosis-associated pelvic pain)

• having another diagnosed/symptomatic chronic pain condition besides migraines withan average pain score >3/10 in the last month when not consuming pain relievers, orthat requires daily treatment with opioids (ex. hydrocodone, oxycodone, codeine,morphine, hydromorphone, tapentadol, tramadol) or neuromodulators (also knownsometimes as antidepressants [ex. amitriptyline, nortriptyline, imipramine,duloxetine, milnacipran, venlafaxine] or antiseizure medications [ex. topiramate,gabapentin, pregabalin, carbamazepine, lamotrigine])

• current or past history of stomach ulcers

• current or past history of gastrointestinal (GI) bleeding

• diagnosis of peptic ulcer disease

• current or past history of renal disorders

• current or past history of adrenal dysfunction

• diagnosis of liver disorders

• diagnosis of chronic acid reflex (i.e. GERD)

• Diagnosis of Crohn's disease or ulcerative colitis

• Coagulopathy

• Prolactinoma

• Von Willebrand disease

• Platelet disorders

• High blood pressure that is difficult to manage

• gastrointestinal conditions or surgeries that affect naproxen absorption

• bleeding disorders

• heart failure

• a history of stroke

• a history of heart attack

• active genitourinary or sexually transmitted infection

• allergy to non-steroidal anti-inflammatory drugs (NSAIDs) or their ingredients

• individuals who take the following medications: anticoagulants (i.e. warfarin),lithium, diuretics, antacids, angiotensin-converting enzyme (ACE) inhibitors,methotrexate, cholestyramine, or probenecids.

• Unmanaged diabetes (i.e. Fasting Blood Glucose: ≥ 126 mg/dL (≥ 7.0 mmol/L),Non-Fasting/Random Blood Glucose: ≥ 200 mg/dL (≥ 11.1 mmol/L), Hemoglobin A1c (HbA1c): ≥ 6.5%)

• Uncontrolled thyroid function (i.e. Hypothyroidism (Underactive Thyroid):Thyroid-Stimulating Hormone (TSH): > 4.5 mIU/L (mild) or > 10 mIU/L (severe) FreeT4: Below the lower end of the reference range (usually < 0.9 ng/dL)

• Hyperthyroidism (overactive thyroid) (i.e. TSH: < 0.4 mIU/L (Suppressed orundetectable), Free T4: Above the upper end of the reference range (usually > 2.0ng/dL)

• Liver dysfunction (i.e. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) or bilirubin (unless known diagnosis of Gilbert's syndrome) ≥ 1.5 times theupper limit of the reference range)

• Kidney dysfunction (i.e. Serum creatinine > 1.1 mg/dL.)