Which of the following is not a risk factor for dysmenorrhea?

• A. Smoking
• B. Regular exercise
• C. Young age
• D. Nulliparity

Answer: (B)

Dysmenorrhea pain is driven by prostaglandin-mediated uterine contractions, which are more pronounced in certain conditions and life stages. Regular exercise tends to protect against dysmenorrhea rather than increase risk. Physical activity can lower prostaglandin production, boost endorphins, improve pelvic blood flow, and reduce stress, all of which help lessen both the frequency and intensity of menstrual cramps.

In contrast, smoking is linked to higher prostaglandin activity and vasoconstriction, making cramps worse. Younger age is associated with a higher incidence of dysmenorrhea, particularly in adolescents, and nulliparity (not having borne a child) is also a known risk factor, with symptoms often decreasing after childbirth. Therefore, the option describing regular exercise is not a risk factor and is the best answer.