Dysmenorrheic Women Research Articles

Efficacy of Ginger in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-analysis.

It has been evidenced that very few systematic reviews have examined the effectiveness of ginger for pain duration and its severity among women with primary dysmenorrhea. This meta-analysis was therefore performed to methodically incorporate and significantly evaluate randomized controlled ginger studies for the treatment of primary dysmenorrhea. The literature was searched using PubMed, Embase, Ovid, ClinicalKey, Medline, and electronic database. We have analyzed clinical trials by comparing ginger with placebo and non-steroidal anti-inflammatory drugs in women with primary dysmenorrhea. The primary outcomes assessed in our meta-analysis were pain severity and pain duration. Secondary outcomes were change in bleeding, side effects of the drug, and rate of satisfaction. We have screened a total of 638 studies, out of which narrative synthesis was formulated for eight studies. We have performed a meta-analysis of five trials examining ginger with placebo and other two randomized controlled trials comparing ginger with a non-steroidal anti-inflammatory drug (NSAID); it seems to be more helpful for relieving menstrual pain than a placebo (mean difference [MD] = 2.67, 95% CI = 3.51-1.84, P = 0.0001, I2 = 86%), although it was found that ginger and NSAIDs were equally effective in pain severity (risk ratios [RR] = 1.15, 95% CI = 0.53-2.52, P = 0.72, I2 =77%). We have not observed any significant difference between ginger and placebo on pain duration among primary dysmenorrheic women (MD = -2.22, 95% CI = -7.62-3.18, P = 0.42, I2 = 56%). Accessible information proposes that oral ginger can be a compelling treatment for primary dysmenorrhea. This meta-analysis strongly supports the requirement for high methodological quality consistency for upcoming trials.

Development and validation of a real‐time method characterizing spontaneous pain in women with dysmenorrhea

Prior research has primarily focused on static pain assessment, largely ignoring the dynamic nature of pain over time. We used a novel assessment tool for characterizing pain duration, frequency, and amplitude in women with dysmenorrhea and evaluated how these metrics were affected by naproxen treatment. Dysmenorrheic women (n = 25) rated their menstrual pain by squeezing a pressure bulb proportional to the magnitude of their pain. To evaluate whether bulb squeezing was affected by naproxen, we compared parameters before and after naproxen. We also analyzed the correlation between pain relief on a numerical rating scale to changes in bulb squeezing parameters. Random bulb-squeezing activity in pain-free participants (n = 14) was used as a control for nonspecific effects or bias. In dysmenorrheic women, naproxen reduced the duration of the squeezing during a painful bout, the number of painful bouts and bout intensity. Before naproxen, the correlation between these bulb squeeze parameters and self-reported pain on numeric rating scale was not significant (R2 = 0.12, p = 0.304); however, there was a significant correlation between changes in bulb squeeze activity and self-reported pain relief after naproxen (R2 = 0.55, p < 0.001). Our study demonstrates a convenient technique for continuous pain assessment, capturing three different dimensions: duration, frequency, and magnitude. Naproxen may act by reducing the duration and frequency of episodic pain in addition to reducing the severity. After further validation, these methods could be used for other pain conditions for deeper phenotyping and assessing novel treatments.

Effect of traditional Chinese medicine formula GeGen decoction on primary dysmenorrhea: A randomized controlled trial study

Ethnopharmacological relevanceGeGen Decoction, a well-known Chinese herbal formula, is widely used in China and other Asian countries to treat gynecological diseases, including primary dysmenorrhea. Pharmacological studies have confirmed that GeGen Decoction is able to inhibit spasmodic contractions of the uterus in vivo and in vitro. Aim of the studyThe objective of this study is to examine the efficacy and safety of GeGen Decoction on primary dysmenorrheic patients. MethodsThis was a randomized, double-blinded, placebo-controlled trial. GeGen Decoction or placebo was administered a week before the expected start of each cycle for three consecutive menstrual periods. Between-group differences in pain intensity were detected by visual analogue scale (VAS). In addition, serum levels of arginine vasopressin (AVP) and estrogen (E) were examined by enzyme-linked immunosorbent assay. Metabolomic analysis was further used to evaluate the influence of GeGen Decoction on the metabolomics of primary dysmenorrheic patients. ResultsA total of 71 primary dysmenorrheic women were recruited and 30 participants met the criteria were randomized into GeGen Decoction or placebo group. After three consecutive menstrual cycles’ treatments, the VAS score of the GeGen Decoction group was significantly lower than that of the placebo group. Both serum levels of AVP and E decreased after GeGen Decoction administration, while the placebo seemed to have little effect on either of the index. Moreover, after GeGen Decoction treatment, seven important metabolites were identified by metabolomic analysis compared to the placebo group. No abnormalities in blood biochemical and routine physical examination pre and post GeGen Decoction intervention were observed. ConclusionsGeGen Decoction can remarkably relieve the severity of menstrual pain without obvious adverse effects. Its therapeutic effect on primary dysmenorrhea might be related to the regulation of pituitary hypothalamic ovarian hormones, and interfering with the metabolic change.

Low Serum Naproxen Concentrations Are Associated with Minimal Pain Relief: A Preliminary Study in Women with Dysmenorrhea.

Incomplete pain relief after administration of nonsteroidal anti-inflammatory drugs (NSAIDs) is common, but it is unknown whether malabsorption or heightened metabolism contributes to NSAID resistance. To explain the etiology of NSAID resistance, we evaluated naproxen absorption and metabolism in relation to pain relief in a pilot study of women with dysmenorrhea. During menses, participants completed before and after naproxen ingestion pain assessments. Analgesic effectiveness was calculated as a percent change in pain rating before and after naproxen administration. To evaluate the impact of malabsorption, the correlation between analgesic effectiveness and serum naproxen was analyzed. To identify whether hypermetabolism contributes to NSAID resistance, we also analyzed the metabolite O-desmethylnaproxen. Serum naproxen and O-desmethylnaproxen concentrations of the dysmenorrheic cohort (N = 23, 126 ± 10 µg/mL, 381 ± 56 ng/mL) and healthy controls (N = 12, 135 ± 8 µg/mL, 355 ± 58 ng/mL) were not significantly different (P > 0.05), suggesting that menstrual pain does not affect drug absorption and metabolism. However, nine dysmenorrhea participants had levels of analgesic effectiveness <30%. Among dysmenorrheic women, analgesic effectiveness was correlated with serum naproxen (r = 0.49, P = 0.019) and O-desmethylnaproxen (r = 0.45, P = 0.032) concentrations. After controlling for other gynecological diagnoses, a multivariate model analysis confirmed that lower serum naproxen concentrations were associated with reduced pain relief (P = 0.038). Our preliminary findings suggest that poor drug absorption contributes to ineffective pain relief in dysmenorrheic women. Future studies should explore whether malabsorption contributes to NSAID resistance for other pain conditions.

Effects of thermotherapy and transcutaneous electrical nerve stimulation on patients with primary dysmenorrhea: A randomized, placebo-controlled, double-blind clinical trial

ObjectivesTo evaluate the effects of thermotherapy and transcutaneous electrical nerve stimulation (TENS) on pain intensity, pressure pain threshold (PPT) and conditioned pain modulation (CPM) in patients with primary dysmenorrhea (PD). DesignA randomized, placebo-controlled, double-blind clinical trial. SettingPhysiotherapy Department of the Universidade Cidade de São Paulo, São Paulo (Brazil). InterventionsEighty-eight dysmenorrheic women were randomly allocated into four groups: Thermotherapy + TENS(n = 22), Thermotherapy(n = 22), TENS(n = 22) and Placebo(n = 22). Thermotherapy was applied by microwave diathermy (20 min), and TENS (200 μs, 100 Hz, 30 min), into the lower abdomen both. Main outcome measuresPain intensity was measured using the numeric rating scale (NRS) and the McGill Pain Questionnaire (Br-MPQ). PPT and CPM were recorded from women’s abdominal and lumbar. The evaluation was done in 5 times: baseline, after 20, 50, 110 min and 24 h from intervention. ResultsThere was a significant decrease in the NRS for Thermotherapy + TENS vs. TENS, for Thermotherapy vs. TENS and for Placebo, after 20 min; for Thermotherapy vs. TENS and for Placebo, after 110 min and 24 h. Abdome PPT increased in the Thermotherapy + TENS vs. TENS and Placebo, after 50 min; for Thermotherapy + TENS vs. Placebo and for Thermotherapy vs. Placebo, after 110 min. No changes in lumbar PPT and CPM were observed. ConclusionsThe use of thermotherapy reduced NRS compared to the TENS and Placebo after 20, 110 min and 24 h. Thermotherapy demonstrated an increase in the PPT in the abdomen after 50 and 110 min and decreased the Br-MPQ scores after 110 min in patients with PD.

Persistent autonomic dysfunction and bladder sensitivity in primary dysmenorrhea

Menstrual pain, also known as dysmenorrhea, is a leading risk factor for bladder pain syndrome (BPS). A better understanding of the mechanisms that predispose dysmenorrheic women to BPS is needed to develop prophylactic strategies. Abnormal autonomic regulation, a key factor implicated in BPS and chronic pain, has not been adequately characterized in women with dysmenorrhea. Thus, we examined heart rate variability (HRV) in healthy (n = 34), dysmenorrheic (n = 103), and BPS participants (n = 23) in their luteal phase across a bladder-filling task. Both dysmenorrheic and BPS participants reported increased bladder pain sensitivity when compared to controls (p’s < 0.001). Similarly, dysmenorrheic and BPS participants had increased heart rate (p’s < 0.01), increased diastolic blood pressure (p’s < 0.01), and reduced HRV (p’s < 0.05) when compared to controls. Dysmenorrheic participants also exhibited little change in heart rate between maximum bladder capacity and after micturition when compared to controls (p = 0.013). Our findings demonstrate menstrual pain’s association with abnormal autonomic activity and bladder sensitivity, even two weeks after menses. Our findings of autonomic dysfunction in both early episodic and chronic visceral pain states points to an urgent need to elucidate the development of such imbalance, perhaps beginning in adolescence.

Abdominal skeletal muscle activity precedes spontaneous menstrual cramping pain in primary dysmenorrhea

Dysmenorrhea is a pervasive pain condition that affects 20-50% of reproductive-aged women. Distension of a visceral organ, such as the uterus, could elicit a visceromotor reflex, resulting in involuntary skeletal muscle activity and referred pain. Although referred abdominal pain mechanisms can contribute to visceral pain, the role of abdominal muscle activity has not yet been investigated within the context of menstrual pain. The goal of this study was to determine whether involuntary abdominal muscle activity precedes spontaneous episodes of menstrual cramping pain in dysmenorrheic women and whether naproxen administration affects abdominal muscle activity. Abdominal electromyography activity was recorded from women with severe dysmenorrhea (n= 38) and healthy controls (n= 10) during menses. Simultaneously, pain was measured in real time using a squeeze bulb or visual analog rheostat. Ninety minutes after naproxen administration, abdominal electromyography activity and menstrual pain were reassessed. As an additional control, women were also recorded off menses, and data were analyzed in relation to random bulb squeezes. Because it is unknown whether mechanisms of menstrual cramps are different in primary or secondary dysmenorrhea/chronic pelvic pain, the relationship between medical history and abdominal muscle activity was examined. To further examine differences in nociceptive mechanisms, pressure pain thresholds were also measured to evaluate changes in widespread pain sensitivity. Abdominal muscle activity related to random-bulb squeezing was rarely observed in healthy controls on menses (0.9 ± 0.6 episodes/hour) and in dysmenorrhea participants off menses (2.3 ± 0.6 episodes/hour). In dysmenorrheic participants during menses, abdominal muscle activity frequently preceded bulb squeezing indicative of menstrual cramping pain (10.8 ± 3.0 episodes/hour; P < .004). Whereas 45% of the women with dysmenorrhea (17 of 38) had episodes of abdominal muscle activity associated pain, only 13% (5 of 38) had episodes after naproxen (P= .011). Women with the abdominal muscle activity-associated pain were less likely to have a diagnosis for secondary dysmenorrhea or chronic pelvic pain (2 of 17) than women without this pain phenotype (10 of 21; P= .034). Similarly, women with the abdominal muscle activity-associated pain phenotype had less nonmenstrual pain days per month (0.6 ± 0.5) than women without the phenotype (12.4 ± 0.3; P= .002). Women with abdominal muscle activity-associated pain had pressure pain thresholds (22.4 ± 3.0 N) comparable with healthy controls (22.2 ± 3.0 N; P= .967). In contrast, women without abdominal muscle activity-associated pain had lower pressure pain thresholds (16.1± 1.9 N; P= .039). Abdominal muscle activity may contribute to cramping pain in primary dysmenorrhea but is resolvable with naproxen. Dysmenorrheic patients without cramp-associated abdominal muscle activity exhibit widespread pain sensitivity (lower pressure pain thresholds) and are more likely to also have a chronic pain diagnosis, suggesting their cramps are linked to changes in central pain processes. This preliminary study suggests new tools to phenotype menstrual pain and supports the hypothesis that multiple distinct mechanisms may contribute to dysmenorrhea.

Effect of pulsed electromagnetic field on menstrual distress in primary dysmenorrhic women

Background Primary dysmenorrhea is a common menstrual cramp that is recurrent and is not owing to other diseases and is a common cause of stay at home and school or work. Purpose The purpose of this study was to investigate the effect of pulsed electromagnetic field (PEMF) on menstrual distress in primary dysmenorrheic women. Patients and methods A total of 40 women having primary dysmenorrhea were selected from Physical Therapy Department in Al Mataria Teaching Hospital in Cairo. Their ages ranged from 20 to 30 years. They were divided randomly into two groups equal in number: group A (study group), treated with the PEMF, three times/week for 3 months, with each session lasted for 30 min, in addition to medical treatment, and group B (control group, which received medical treatment only (NSAIDs). Menstrual distress questionnaire and visual analog scale were used for assessment of menstrual distress and pain before treatment and after treatment for both groups A and B. Results The results showed that there is a significant improvement in menstrual distress and pain scores in both groups A and B after treatment, in favor of group A. Conclusion It was concluded that PEMF is effective in improving dysmenorrheic pain and menstrual distress score.

Comparative study of response to experimental cold pain in dysmenorrheic and nondysmenorrheic women

Background: There has been keen research interest into the gender differences in tolerance of pain sensation. Dysmenorrheic pain is common among women of reproductive age group. Assessment of pain perception will result in better management of this chronic state. In this era of personalized medicine, optimizing analgesic treatment in patients with chronic pain is essential. Aims and Objectives: To compare levels of pain threshold and pain tolerance determined using cold pressor test in dysmenorrheic and nondysmenorrheic women during a single menstrual cycle in different phases. Materials and Methods: This is a comparative study done on 31 dysmenorrheic and nondysmenorrheic women between the ages of 18 and 22 years conducted in a tertiary care institution. We performed cold pressor test on 1st, 14th, and 21st day of menstrual cycle denoting the menstrual phase, late follicular phase, and luteal phase on the participants. Results: The levels of pain tolerance and pain threshold were significantly higher in dysmenorrheic women in comparison to nondysmenorrheic women. Conclusions: Higher thresholds may be supportive of a model of pain adaptation as dysmenorrheic women tend to compare cold pressor pain with internal menstrual pain. The knowledge of varying pain perception would benefit the gynecologists in dose adjustments of analgesics.

Osteopathic Manipulative Treatment of Primary Dysmenorrhea and Related Factors: A Randomized Controlled Trial

Objectives: This study is aimed to evaluate if the osteopathic manipulative treatment (OMT) is effective in patients with primary dysmenorrhea (PD). Methods: Randomized single-blinded controlled trial with OMT group and lighttouch treatment (LTT) group. Recruited women were 18-40 years (mean age 27 years), with regular menstrual cycle, normal body mass index (BMI), and a medical diagnosis of PD. Intervention: Patients received five OMT or five LTT over a menstrual cycle. The primary outcomes were average menstrual pain assessed by the numeric rating scale (NRS), the duration of pain, and quality of life (QoL) assessed by the SF-12 Short Form Health Survey and Patient Global Impression Change (PGIC). The secondary outcomes were NSAIDs intake, hours of absence from school/work, and menstrual-related symptoms. Results: 31 subjects were enrolled, of which five were excluded and the remaining 26 were randomized. Patients in OMT group had significant improvement in every outcome, including the average menstrual pain that decreased from 5.35 ± 0.28 to 1.98 ± 0.24 (-63.0%; p<0.001). The mean SF-12 physical component score (PCS) improved from 31.35 ± 1.70 to 49.56 ± 1.92 (+58.1%, p<0.001), the mean SF-12 mental component score (MCS) improved from 38.36 ± 1.16 to 52.04 ± 0.94 (+35.7%; p<0.001). LTT group showed no improvements. Conclusion: OMT was effective in reducing menstrual pain and improving Quality of Life of dysmenorrheic women.

English

BACKGROUND: Dysmenorrhea is the most common gynecologic disorder among female adolescents, with a prevalence of 60% to 93%. Primary dysmenorrhea, painful menstruation without pelvic abnormalities, may be associated with vomiting, fatigue, back pain, headaches, dizziness, and diarrhoea. MATERIALS AND METHODS: This is a comparative and cross sectional Study. Thirty one dysmenorrheic women and non dysmenorrheic women between the age group of 18-26 years participated in this study. All participants satisfied inclusion and exclusion criteria and gave informed consent. We performed Cold Pressor Test on 1st, 14th and 21st day of menstrual cycle denoting the menstrual phase, late follicular phase and luteal phase on the participants. Radial pulse rate was recorded before and after the Cold Pressor test, expressed in beats per minute. Blood pressure was recorded in sitting position just before and after immersion using sphygmomanometer, expressed as mmHg. RESULTS: The SBP difference was highest in the dysmenorrheic women (10.52±2.68) when compared to non dymenorrheic women (8.52±1.93) on the 1st day which was statistically significant. The SBP change was lowest on the 14th day in the dysmenorrheic women (6.52±2.42) when compared to non dymenorrheic women (3.74±1.00) which is statistically significant. The DBP difference was highest in the dysmenorrheic women (4.90±1.54) when compared to non dymenorrheic women (4.06±0.63) on the 1st day which was moderately significant. The DBP change was lowest on the 14th day in the dysmenorrheic women (4.06±1.50) when compared to non dymenorrheic women (2.26±0.68) which is statistically significant. In dysmenorrheic women, there was difference in pulse rate when comparing the 3 episodes that is 1st, 14th day & 21st day. In non dysmenorrheic women, there was difference in pulse rate when comparing the 3 episodes that is 1st, 14th day & 21st day. CONCLUSIONS: We concluded that dysmenorrheic women had increased cardiovascular response to experimental pain across menstrual cycle when compared to non dysmenorrheic women which could be attributed to activation of Sympatho -adrenal medullary

Prevalence, impact and treatment of primary dysmenorrhea in workers of an Academic and Research Institute

Dysmenorrhea is one of the cyclical processes in chronic pelvic pain. Dysmenorrhea in women causes a high psychosocial and economic impact. For this reason, we conducted a study to assess the prevalence, impact and use of drugs for the treatment of dysmenorrhea among workers of an Educational and Research Institute. A prevalence of dysmenorrhea of 57.2% was found. About a half (49.4%) of women with dysmenorrhea reported that it limited their daily activities in 4.1 ± 2.4 cycles per year. 29.3% reported absenteeism by at least 2.7 ± 1.4 (range 1-5) cycles per year. Of the women with dysmenorrhea, only 34.9% consulted a doctor and the most prescribed drugs were over the counter medications with metamizol and butylscopolamine (25.0%), another medicine with paracetamol, pamabrom and pyrilamine (Syncol®, 16.7%) naproxen (12.5%) and mefenamic acid (12.5%). On the other hand, self-medication was practiced by 54.2% of women with dysmenorrhea and the most used drugs were Syncol® (28.9%), naproxen (17.8%), metamizol with butylscopolamine (13.3%) and dipyrone (6.7%). Our data suggest a significant prevalence of primary dysmenorrhea and dysmenorrheic women used many drugs for self-medication, but rarely come to medical services.

Women With Dysmenorrhea Are Hypersensitive to Experimental Deep Muscle Pain Across the Menstrual Cycle

Primary dysmenorrhea is a common painful condition in women that recurs every month across the reproductive years. The recurrent nociceptive input into the central nervous system that occurs during menstruation each month in women with dysmenorrhea is hypothesized to lead to increased sensitivity to painful stimuli. We investigated whether women with primary dysmenorrhea are hyperalgesic to deep muscle pain induced by a cleanly nociceptive method of hypertonic saline injection. Pain stimulation was applied both within an area of referred menstrual pain (lower back) and at a remote site outside of referred menstrual pain (forearm) in 12 healthy women with severe dysmenorrhea and 9 healthy women without dysmenorrhea, at 3 phases of the menstrual cycle: menstruation and follicular and luteal phases. Women rated their pain severity on a 100-mm visual analog scale every 30 seconds after injection until the pain subsided. In both groups of women, menstrual cycle phase had no effect on the reported intensity and duration of muscle pain. However, women with dysmenorrhea had increased sensitivity to experimental muscle pain both at the site of referred pain and at a remote nonpainful site, as assessed by peak pain severity visual analog scale rating, area under the visual analog scale curve, and pain duration, compared to women without dysmenorrhea. These data show that women with severe primary dysmenorrhea, who experience monthly menstrual pain, are hyperalgesic to deep muscle pain compared to women without dysmenorrhea. PerspectiveOur findings that dysmenorrheic women are hyperalgesic to a clinically relevant, deep muscle pain in areas within and outside of referred menstrual pain indicates lasting changes in pain sensitivity outside of the painful period during menstruation.

Altered Cytokine Gene Expression in Peripheral Blood Monocytes across the Menstrual Cycle in Primary Dysmenorrhea: A Case-Control Study

Primary dysmenorrhea is one of the most common gynecological complaints in young women, but potential peripheral immunologic features underlying this condition remain undefined. In this paper, we compared 84 common cytokine gene expression profiles of peripheral blood mononuclear cells (PBMCs) from six primary dysmenorrheic young women and three unaffected controls on the seventh day before (secretory phase), and the first (menstrual phase) and the fifth (regenerative phase) days of menstruation, using a real-time PCR array assay combined with pattern recognition and gene function annotation methods. Comparisons between dysmenorrhea and normal control groups identified 11 (nine increased and two decreased), 14 (five increased and nine decreased), and 15 (seven increased and eight decreased) genes with ≥2-fold difference in expression (P<0.05) in the three phases of menstruation, respectively. In the menstrual phase, genes encoding pro-inflammatory cytokines (IL1B, TNF, IL6, and IL8) were up-regulated, and genes encoding TGF-β superfamily members (BMP4, BMP6, GDF5, GDF11, LEFTY2, NODAL, and MSTN) were down-regulated. Functional annotation revealed an excessive inflammatory response and insufficient TGF-β superfamily member signals with anti-inflammatory consequences, which may directly contribute to menstrual pain. In the secretory and regenerative phases, increased expression of pro-inflammatory cytokines and decreased expression of growth factors were also observed. These factors may be involved in the regulation of decidualization, endometrium breakdown and repair, and indirectly exacerbate primary dysmenorrhea. This first study of cytokine gene expression profiles in PBMCs from young primary dysmenorrheic women demonstrates a shift in the balance between expression patterns of pro-inflammatory cytokines and TGF-β superfamily members across the whole menstrual cycle, underlying the peripheral immunologic features of primary dysmenorrhea.

Characteristics and Determinants of Primary Dysmenorrhea in Young Adults

Problem statement: Dysmenorrhea is believed to be on rise affecting activities of women adversely. It was considered worthwhile to identify risk factors for dysmenorrhea, since such information is useful in designing management process. Approach: A Cross-sectional study was conducted on 500 healthy females aged 18-28 years. Standardized Self-reporting questionnaires were used to obtain relevant data. The categorical data was analyzed using Chi-sq, correlation and regression analyses by SPSS version 16. Results: Majority (72.9%) of the participants experienced menstrual pain. More than 50% dysmenorrheic subjects experienced pain every menstrual cycle. Among the factors studied menstrual flow, length of flow and family history exhibited positive association while family size had an inverse association to a significant extent (p = 0.01 ). BMI, SFT did not exhibit significant effect, where as time spent in standing was significantly correlated to pain. Dysmenorrheic women scored significantly higher for all the subscales on menstrual attitude questionnaire, wherein certain components describing menstruation as debilitating event or predictability had high score significant at 1% level. Conclusion: Dysmenorrhea is becoming a highly debilitating event among young adult females with an increasing prevalence rate. The notorious determining factor may be the family history baring significant association to dysmenorrhea. Attitude towards menstruation and the posture is important contributory factors.

Four-agents-decoction suppresses HER2 expression in endometriosis

OBJECTIVE: Safety and molecular mechanism of Four-Agents-Decoction (FADD, or Si-Wu-Tang, SWT: water extracts of Si-Wu), a traditional Chinese herb formula, on endometriosis. (Dysmenorrhea is common in female of reproductive age. Among those dysmenorrheic women, some dysmenorrhea are associated with pelvic diseases such as endometriosis, adenomyosis or uterine myoma. Endometriosis is an important cause of persistent dysmenorrhea. Regular use of FADD to treat dysmenorrhea might unintentionally expose endometriosis to FADD.

Reproductive hormones in plasma over the menstrual cycle in primary dysmenorrhea compared with healthy subjects

The pathogenesis of primary dysmenorrhea is still poorly understood. The objective of the present investigation was to study differences in plasma concentrations of reproductive hormones in women with primary dysmenorrhea vs. healthy controls. In a prospective, parallel-group study we determined the plasma concentrations of oxytocin, vasopressin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (17β-E2), progesterone and prostaglandin F2α metabolite (15-keto-13,14-dihydro-PGF2α) over one menstrual cycle in eight women with primary dysmenorrhea and eight healthy volunteers. In dysmenorrheic women the plasma concentration of oxytocin was significantly higher at menstruation (p = 0.0084) and that of vasopressin significantly lower at ovulation (p = 0.0281) compared with healthy women. They had also higher FSH levels in the early follicular phase (p = 0.0087) and at menstruation (p = 0.0066) and the 17β-E2 concentration was higher in the late follicular phase (p = 0.0449). No differences were seen for LH, progesterone and PGF2α metabolite. The differences of oxytocin, vasopressin, FSH and 17β-E2 concentrations found in plasma suggest an involvement of these hormones in mechanisms of primary dysmenorrhea. These mechanisms seem to be mainly regulated through the hypothalamus and pituitary. The influence of oxytocin on the non-pregnant uterus seems to be more important than earlier believed.

Specific Physiological Responses in Women with Severe Primary Dysmenorrhea during the Menstrual Cycle

This study examined the specific physiological responses of women with primary dysmenorrhea during the severely painful menstrual (days 1-2 of menstruation) and the non-painful follicular phases (days 5-8 after the onset of menstruation). Subjects consisted of 10 severe primary dysmenorrheic (Group P) and 10 non-dysmenorrheic women (Group C) with regular menstrual cycles. However, only 9 out of 10 and 8 out of 10 subjects of Groups P and C participated during the follicular phase. Physiological measures were taken in a resting state for 60 min. In the menstrual phase, the pain ratings and secretory immunoglobulin A (s-IgA) concentrations of Group P were significantly higher than those of Group C, with relatively significant decreases in the leg-skin temperature in the former as well. In addition, the systolic (SBP) and diastolic blood pressure (DBP) at 45 min after rest in Group P were significantly higher than those found in Group C. These reactions strongly suggest activation of the sympathetic-adrenal-medullary axis (SAM axis) by painful stress. Furthermore, the low-frequency (LF) component of the SBP variability (SBPV) was significantly higher in Group P than Group C, even during the follicular phase. These findings imply that Group P may well have elevated activities of the SAM axis throughout the whole menstrual cycle. As such, it suggests that dysmenorrheic women may be affected by certain stressors other than pain per se and pain-derived emotions throughout the whole menstrual cycle. The findings also indicate that women with dysmenorrhea have more sensitive responses to the SAM system than non-dysmenorrheic women during stress. Moreover, the high-frequency (HF) component of heart rate variability (HRV), or the index for the vagus nerve activity, displayed a consistently higher value in Group P than C. It is postulated that the human body may have responded to pain in an attempt to maintain the homeostatic state by enhancing vagus nerve activity.

Pain Perception in Women With Dysmenorrhea

In Brief OBJECTIVE To determine if systemic processing of pain differs in women with and without dysmenorrhea. METHODS Twenty-two dysmenorrheic women and 31 nondysmenorrheic women were studied by pain threshold and supra-threshold magnitude estimation to heat stimuli, pain-evoked potentials by laser stimuli, and anxiety scores four times across their menstrual cycles. RESULTS Significant differences were found between dysmenorrheic and nondysmenorrheic women. In all four examinations across the menstrual cycle, dysmenorrheic women had longer latencies of pain-evoked potentials (383.08 ± 6.8 msec versus 345.05 ± 7.0 msec, P < .001), higher magnitude estimations on visual analog scale of supra-threshold pain (83.29 ± 2.87 versus 63.50 ± 3.82, P < .001), and higher state anxiety scores (37.69 ± 1.7 versus 29.20 ± 1.9, P = .002). CONCLUSION Women with dysmenorrhea show enhanced pain perception compared to nondysmenorrheic women. This augmentation of pain perception may be part of the development of dysmenorrhea. Women with dysmenorrhea have increased systemic pain perception across the menstrual cycle.

Pain perception in women with dysmenorrhea

OBJECTIVE: To determine if systemic processing of pain differs in women with and without dysmenorrhea. METHODS: Twenty-two dysmenorrheic women and 31 nondysmenorrheic women were studied by pain threshold and supra-threshold magnitude estimation to heat stimuli, pain-evoked potentials by laser stimuli, and anxiety scores four times across their menstrual cycles. RESULTS: Significant differences were found between dysmenorrheic and nondysmenorrheic women. In all four examinations across the menstrual cycle, dysmenorrheic women had longer latencies of pain-evoked potentials (383.08 ± 6.8 msec versus 345.05 ± 7.0 msec, P < .001), higher magnitude estimations on visual analog scale of supra-threshold pain (83.29 ± 2.87 versus 63.50 ± 3.82, P < .001), and higher state anxiety scores (37.69 ± 1.7 versus 29.20 ± 1.9, P = .002). CONCLUSION: Women with dysmenorrhea show enhanced pain perception compared to nondysmenorrheic women. This augmentation of pain perception may be part of the development of dysmenorrhea.