Patients presented with primary dysmenorrhea composed the study population. One gram paracetamol and 100 mg tramadol in 100 ml saline with a slow infusion were compared in ceasing dysmenorrhea in the emergency department

Patients over 18 years old who presented with dysmenorrhea composed the study population. Patients received painkiller within the last six hours, physical findings consistent with peritoneal irritation, allergy to the study drugs, renal or liver failure, drug addiction, pregnancy or woman with lactation and denied to give inform consent were the exclusion criteria. The pain of the study patients is measured with the visual analogue scale at baseline, 15th and 30th minutes and 1 hour after study drug administration. At the end of the 60 minutes, rescue drug need is also recorded.

Inclusion Criteria:

• Patients with moderate to severe primary dysmenorrhea and visual analog scale (VAS) pain scores ≥40
• Patients over 18 years old

Exclusion Criteria:

• denied to give inform consent, irregular menstrual cycles, known or suspected secondary dysmenorrhea
• Renal or liver failure
• Allergy to the study drugs
• Receiving pain killer within the last 6 hours.
• Physical examination findings consistent with peritoneal irritation
• Pregnancy or patients with lactation
• Drug or Alcohol Abuse