Can you advise for primary dysmenorrhea ?

Primary: primary dysmenorrhea starts shortly after your periods start (menarche). Birth control especially continuous birth control works well. Add NSAIDs like ibuprofen or Ponstel (mefenamic acid) seems to help, but you have to start taking it when the cramps start and take it 2-3 times a day no matter what instead of waiting on severe pain

Dysmenorrhea: At age 39, it is really important to have a good Gyn exam. Endometriosis is a not uncommon cause of dysmenorrhea. If normal exam and no other symptoms like painful intercourse or pelvic pain, would try anti prostaglandins. (Motrin/aleve) at the first hint of dysmenorrhea +/- oral contraceptives