Hello! Thanks for your query. Frst-line pharmacologic therapy includes nonsteroidal anti-inflammatory drugs (NSAIDs) and/or estrogen-progestin contraceptives (cyclic, long-cycle, or continuous), depending on the clinical needs of the patient. For you with primary dysmenorrhea desiring contraception, estrogen-progestin contraceptives are a logical choice. For you who do not to use hormonal treatment,and NSAIDs havent relived dysmenorrhea . However, you may need both types of treatment. If who do not achieve adequate pain relief after three months of treatment with NSAIDs and hormonal contraceptives may have secondary dysmenorrhea due to endometriosis or other conditions. Options for you include diagnostic laparoscopy or empiric GnRH agonist therapy. Intrauterine progestin delivery systems (levonorgestrel intrauterine system) have demonstrated some efficacy in women with dysmenorrhea secondary to either proven or suspected endometriosis. Take care