dinoprost and Amenorrhea

Painful menstruation is a cyclic painful condition that adversely affects the woman's wellbeing for a large part of her life. Its pathogenesis is not always understood. Prostaglandins seem to be intimately involved in primary dysmenorrhoea although it is difficult to understand the underlying cause for their excessive secretion. Abnormalities in plasma steroid levels could account for the disturbance, especially significantly elevated plasma levels of estradiol in the luteal phase. Plasma levels of vasopressin appear to be higher in women with dysmenorrhea suggesting a possible aetiological role in the uterine prostaglandin synthesis. The main aim of diagnosis is to distinguish those cases with secondary dysmenorrhoea due to endometriosis and chronic pelvic inflammatory disease and treat them accordingly although the exact role of endometriosis remains unclear. The development of sonographic and magnetic resonance imaging techniques (MRI) allow pre-operative diagnosis of adenomyosis, a difficult to diagnose cause of dysmenorrhea and pelvic pain. Medication is usually required for all cases of moderate to severe painful menstruation. Apart from pharmacological agents, several techniques have been used including relaxation therapy, hypnosis, manipulation, psychotherapy, acupuncture, biofeedback techniques, surgery e.g. Despite the high prevalence of painful menstruation, its frequency and severity is very often underestimated.

Topics: Adolescent; Amenorrhea; Contraceptives, Oral, Hormonal; Dinoprost; Dysmenorrhea; Female; Humans; Pelvic Pain; Prostaglandin Antagonists; Sympathomimetics

Peritoneal fluid from sterile women where the state of the pelvis is changed by endometriosis, inflammation, infection, and in certain cases where it appears normal laparoscopically, can immobilise spermatozoa in minutes or hours. This toxicity against male gametes could be an explanation of the mechanism for such sterility. The tubes and the ovaries are bathed in this liquid in the periovulatory phase when they are largest in size. If these first observations are confirmed fully many theoretical, practical and therapeutic implications must follow.

Topics: Amenorrhea; Body Fluids; Dinoprost; Endometriosis; Female; Humans; Immobilization; Infertility; Male; Pelvic Inflammatory Disease; Peritoneal Cavity; Prostaglandins E; Prostaglandins F; Sperm Motility; Sterilization, Reproductive