Primer Dismenore Patogenezinde İskemi ve Oksidatif Stresin Rolü

Abstract

Objective: Primary dysmenorrhea is pelvic pain without pathologic reasons during the menstrual period, induced by prostaglandin synthesis. Last studies have shown the relation of primary dysmenorrhea with ischemia/hypoxia. Ischemia-Modified Albumin (IMA) is a marker used for detecting the early period of ischemia. In this study we planned to investigate role of ischemia and oxidative stress in etiopathogenesis of primary dysmenorrhea according to the severity of its symptomatology . Materials and Methods: 47 female university students with primary dysmenorrhea were included in this study. Each student passed through the full physical and gynecological examination. Visual Analog scale (VAS) was used to measure pain intensity (no pain-score of 0;worst imaginable pain-score of 10). VAS grading from 1-4 was accepted as mild; 5-7 as moderate; and 8-10 as severe pain. Blood samples were collected from all participants on the third day of mens period. After separation of serum, they were kept at -80°C until analyzed. Serum IMA levels were measured by albumin cobalt binding (CAB) test. The results were corrected by using serum albumin values-expressed as corrected IMA(C-IMA). Malondialdehyde (MDA) levels were measured by using thiobarbituric acid reactive substance (TBARS) and the results were expressed as µmol/L. Results: C-IMA values were: 0.867±0.23 in mild; 1.279±0.31 in moderate and 1.222±0.20 in severe pain group. There were significant difference between the averages of groups with Oneway ANOVA (p<0.024). By using Tukey test the C-IMA values in group with mild pain found significantly lower than the C-IMA values of the group with moderate pain(p = 0,021). MDA results were: 9.01±0.64 in the mild; 11.78±1.97 in the moderate and 15.20± 6.86 severe pain group. The difference between groups with Oneway-ANOVA was statistically significant (p<0.016). Group comparisons with Tukey test showed significant difference between the group with mild dysmenorrhea and the group with severe pain (p<0.016). Conclusions: C-IMA and MDA levels increased in patients with primary dysmenorrhea. Their levels were related with the severity of the pain, suggesting roles of ischemia and oxidative stress in primary dysmenorrhea. Probably pain-generating mechanisms also produce oxidative stress and ischemia. Molecular mechanisms which induce oxidative stress together with ischemia and pain should be investigated in further studies.