Abstract
16 young women (18-35 years old) suffering from severe primary dysmenorrhea were treated with the anti-inflammatory drug Flunalgan (flufenamic acid; N-(a a a-trifluorom-tolyl) anthranilic acid) 125 mg tid or quid during 1 to 3 menstrual periods. In all patients (a total of 31 treated cycles) the drug afforded symptomatic relief. Treatment with other analgesic spasmolytic or tranquilizing drugs or with placebos was ineffective in these patients (72 control cycles). Flufenamic acid inhibits prostaglandin synthetase and the biologic action of prostaglandin F2a on smooth muscle in laboratory animal preparations. The hypothesis is discussed that excessive amounts of prostaglandin originating from breakdown of the pseudodecidual tissue of the premenstrual endometrium during cyclic progesterone withdrawal may be the cause of painful myometrial contractures and of the accompanying gastrointestinal symptoms that characterize this syndrome. Further study of the efficacy and safety of drugs that antagonize prostaglandin synthesis and/or action in the treatment of primary dysmenorrhea seems indicated. (Authors modified)
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