dinoprost and Dysmenorrhea

Dysmenorrhea is a prevalent gynecological disease among women at reproductive age. It is classified as the primary dysmenorrhea and the secondary dysmenorrhea according to the etiology. The primary dysmenorrhea is caused by uterine hypercontraction without any identifiable pelvic lesions, while the secondary dysmenorrhea is incurred by gynecological disorder with pelvic organic lesions. However, the underlying mechanism of dysmenorrhea is not completely clear. Animal models of dysmenorrhea, especially mouse and rat model, are helpful to explore the pathophysiological mechanism of dysmenorrhea, clarify the therapeutic effect of compounds, and guide clinical treatment. The murine model of primary dysmenorrhea is commonly induced by oxytocin or prostaglandin F

Topics: Animals; Dinoprost; Disease Models, Animal; Dysmenorrhea; Female; Humans; Mice; Oxytocin; Rats; Uterus

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

Topics: Diagnosis, Differential; Dinoprost; Dysmenorrhea; Estrogens; Female; Hemorrhagic Disorders; Humans; Menorrhagia; Polycystic Ovary Syndrome; Prognosis; Uterine Diseases; Uterus; Vitamin B 6 Deficiency

Topics: Anovulation; Arachidonic Acid; Dinoprost; Dysmenorrhea; Endometriosis; Female; Humans; Intrauterine Devices; Menorrhagia; Menstruation Disturbances; Premenstrual Syndrome; Prostaglandin Antagonists; Prostaglandins; Uterine Contraction

The physiology and pathology of dysmenorrhea in adolescent girls has become clear in the past 5 years. Although the prime cause of the disorder has not been identified, the obvious rise in PGF2 alpha prostaglandins is an objective biologic sign. As a result, more specific treatment has become possible with more definite and established care of this "condition" which is often distressing to the teenage girl affected.

Topics: Adolescent; Dinoprost; Dysmenorrhea; Female; France; Humans; Ibuprofen; Indomethacin; ortho-Aminobenzoates; Prostaglandin Antagonists; Prostaglandins F; United States

Topics: Corpus Luteum; Dinoprost; Dysmenorrhea; Female; Humans; Labor Onset; Male; Ovulation; Pregnancy; Prostaglandins; Prostaglandins F; Reproduction; Semen; Uterus

Dysmenorrhea with high prevalence has been categorized as primary dysmenorrhea (PD) and secondary dysmenorrhea due to differences in pathogenesis. A significant number of reproductive females suffering from monthly menstruation have to deal with negative impacts on their quality of life, work/study productivity, activities, and social relationships. In addition to medical treatment, exercise has been recognized as a complementary and alternative strategy for disease prevention, alleviation, and rehabilitation. This study aimed to investigate the potential effects of exercise on the severity of primary dysmenorrhea, physiological modulation, and physical fitness. Participants consisted of university students who were enrolled in the study and divided into a non-PD (Control) and a PD group based on recruiting criteria, the latter being randomly assigned to either an untreated dysmenorrhea group or a dysmenorrhea group that underwent 10 weeks of high intensity interval training (HIIT) exercise (Dysmen and DysmenHIIT, respectively). The DysmenHIIT group used spinning bikes and the training intensity was validated by heart rate monitors and BORG rating of perceived exertion. Forms containing participant information (premenstrual symptoms, menstrual distress, and a Short Form McGill Pain Questionnaire) as well as physical fitness, biochemical variables, hormone and prostaglandin (PGE2 and PGF2α) levels were assessed before and after the exercise intervention. After intervention, premenstrual symptoms (anger, anxiety, depression, activity level, fatigue, etc.), menstrual distress symptoms (cramps, aches, swelling, etc.), and pain severity were shown to be significantly mitigated, possibly through hormone (estradiol, prolactin, progesterone, and cortisol) modulation. Furthermore, high-sensitivity C-reactive protein (HsCRP), PGE2 and PGF2α levels were also down-regulated, resulting in the amelioration of uterine contraction and inflammation. Participants' physical fitness, including cardiovascular endurance and explosive force, was significantly improved after HIIT. The 10-week HIIT spinning bike exercise used in this study could be employed as a potential and complementary treatment for PD symptoms alleviation and considered as part of an educational health plan for promoting women's health. However, the effects of HIIT utilizing different exercise methods and accounting for different age populations and secondary PD warrant further investigation.

Topics: Bicycling; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Hormones; Humans; Inflammation; Physical Fitness; Quality of Life

This research apply Dingkun Dan to treat patients with dysmenorrhea of cold stagnation and blood stasis syndrome. This study observed its effectiveness and safety of the treatment of the disease and its influence on the serum prostaglandin F2α, endothefin, pulsatility index and resistant index of uterine artery blood, to explore the possible mechanism of effect of Dingkun Dan in the treatment of dysmenorrhea and provide scientific basis for clinical application. The 75 patients with dysmenorrhea of cold stagnation and blood stasis who met the inclusion criteria, were divided into treatment group (n=37) and control group (n=38) by using random number remainder grouping method. In the treatment group patients were treated with Dingkun Dan, the other group were given Fuke Zaizao Jiaonang. Two groups have same time to take the medicine, three days prior to the menstruation for ten days. Medication for three menstrual cycles was seen as a course of treatment. To observe and compare the two groups of patients before and after treatment VAS score, syndrome integral, serum levels of prostaglandin F2α and endothelin, pulsation index and resistance index of uterine artery blood flow and related safety index changes. Finally makes statistical analysis. It has been identified that, Treatment group and control group can reduce pain symptom of dysmenorrhea patients and improve the syndromes scores, compare with control group, effect of the treatment group is more significant(P<0.01). VAS pain curative effect: the treatment group and control group total effective rate respectively were, 97.22%, 69.44%, markedly effective rate were 83.33%, 30.56%, comparison between two groups, treatment group is better than that of control group(P＜0.01). Syndromes curative effect: the treatment group and control group total effective rate respectively were 97.22%, 94.44%, markedly effective rate was 66.67%, 2.78%, respectively. The comparison between two groups, the total effective rate has no obvious difference, but markedly effective rate of treatment group is better than that of control group(P＜0.01). The treatment group can significantly reduce the patients' serum level of prostaglandin F2α(P<0.01), but no obvious difference was found in the control group before and after treatment. Both groups can significantly reduce the serum level of endothelin(P<0.01), comparison between two groups, the treatment group is more significant(P<0.01).Both treatment group and control group were sign

Topics: Dinoprost; Drugs, Chinese Herbal; Dysmenorrhea; Endothelins; Female; Hemodynamics; Humans; Medicine, Chinese Traditional; Uterine Artery; Uterus

To explore the efficacy and the reproductive endocrinal mechanism of herbal-partitioned moxibustion in the treatment of primary dysmenorrhea.. One hundred and seventy-one cases of primary dysmenorrhea were randomized into an herbal-partitioned moxibustion group (group A), an starch-partitioned moxibustion group (group B) and an acupuncture group (group C), 57 cases in each one. In the group A, moxibustion isolated with herbal medicine was applied to Shenque (CV 8). In the group B, moxibustion isolated with starch was used at Shenque (CV 8). In the group C, acupuncture was given at Sanyinjiao (SP 6). The changes of estradiol (E2), progesterone (P) and prostaglandin levels (PGF2alpha) were observed before and after treatment, and the therapeutic effects were compared among the 3 groups.. The therapeutic effect in the group A was better than those in the other two groups [compared the cured rate: 89.8% (44/49) vs 60.0% (30/50), 60.4% (32/53), both P < 0.05]. In the group A, E2 level [(110.99 +/- 12.90) pg/mL vs (83.94 +/- 8.91) pg/mL, P < 0.05] and PGF2alpha level [(24.58 +/- 3.01) pg/mL vs (14.34 +/- 1.48) pg/mL, P < 0.01] were decreased and P level was increased [(4.65 +/- 0.68) ng/mL vs (6.68 +/- 0.95) pg/mL, P < 0.05]. In the group B and C, PGF2alpha level were reduced. Concerning to the regulating of E2 and PGF2alpha levels, the results in the group A were better than those in the group B and C [(-30.16 +/- 10.20) pg/mL vs (10.79 +/- 15.01) pg/mL, (22.81 +/- 12.22) pg/mL; (-13.10 +/- 2.40) pg/mL vs (-6.52 +/- 1.88) pg/mL, (-3.14 +/- 1.19) pg/mL, (see text) P < 0.05]. Concerning to the regulation of P level, the results in the group A and B were better than that in the group C (all P < 0.05).. The herbal-partitioned moxibustion achieves the significant efficacy on primary dysmenorrhea, which could be related to regulating the reproductive endocrinal level. It decreases E2 and PGF2alpha levels and increases P level.

Topics: Acupuncture Points; Adult; Dinoprost; Dysmenorrhea; Estradiol; Female; Humans; Moxibustion; Progesterone; Young Adult

To observe the clinical curative effect of primary dysmenorrhea and the content of prostaglandin F2alpha (PGF2alpha) in peripheral blood of menstrual periods treated with eye acupuncture therapy.. One hundred and ten cases of primary dysmenorrhea were randomly divided into an eye acupuncture group (60 cases) and a medication group (50 cases). In eye acupuncture group, low energizer area, liver area, kidney area, heart area and spleen area etc. were selected according to the differentiation, and the eye acupuncture therapy was applied. In medication group, Ibuprofen Sustained Release Capsules was taken with oral administration for 300 mg 1-2 days before menses coming or when the symptoms appeared, once every 12 hours, for 3-5 days totally. Three menstrual periods made one session. The content of PGF2alpha in peripheral blood, and the curative effects and recurrence 3 and 6 months after treatment were observed.. After 3 months treatment, compared with the curative effects between both groups, the cured rate was 55.0% (33/60) and the total effective rate was 95.0% (57/60) in eye acupuncture group, which were superior to those of 34.0% (17/50) and 82.0% (41/50) in medication group (both P < 0.05). According to the following-up after 6 menstrual periods, the recurrence rate was 9.1% (3/33), inferior to that of 35.3% (6/11) in medication group. The contents of PGF2alpha in peripheral blood of menstrual periods were all reduced after treatment in two groups (both P < 0.01).. The curative effect of primary dysmenorrhea treated with eye acupuncture is favorable, and the lever of PGF2alpha in peripheral blood of menstrual periods is reduced.

Topics: Acupuncture Therapy; Adolescent; Adult; Dinoprost; Dysmenorrhea; Eye; Female; Humans; Young Adult

To observe therapeutic effect of acupoint application on dysmenorrhea of excess syndrome and its effect on prostaglandins.. The patients with primary dysmenorrhea of excess syndrome were randomly divided into an application group and a medication group. The application group of 31 cases were treated with application of Chinese medicine composed of Zhinanxing (Rhizoma Arisaematis), Sanleng (Rhizoma Sparganii), Ezhu (Rhizoma Zedoariae), etc. at Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6); and the medication group of 30 cases were treated with oral administration of Tianqi Tongjing Capsules. The scores for the pain degrees and the duration of dysmenorrhea were observed and prostaglandin F2alpha (PGF2alpha) and prostaglandin E2 (PGE2) contents in peripheral blood were determined before and after treatment.. The total effective rate of 93.5% in the application group was significantly better than 73.3% in the medication group (P < 0.05); after treatment, the scores of the symptoms were significantly decreased in the two groups (both P < 0.01), with more obvious improvement in the application group than the medication group (P < 0.01). The PGE2 content was significantly increased, and the PGF2alpha content and PGF2alpha/PGE2 were significantly decreased in the application group (all P < 0.01).. Acupoint application has a better therapeutic effect on dysmenorrhea of excess syndrome and has benign regulative action on synthesis of prostaglandins in the patients with primary dysmenorrhea.

Topics: Acupuncture Points; Administration, Oral; Adult; Capsules; Dinoprost; Dinoprostone; Drugs, Chinese Herbal; Dysmenorrhea; Female; Humans; Medicine, Chinese Traditional; Prostaglandins; Syndrome; Treatment Outcome; Young Adult

To observe the clinical therapeutic effect of acupuncture massage for primary dysmenorrhea and its influence on prostaglandin F2alpha level in menstrual fluid.. Ninety patients with primary dysmenorrhea were assigned equally to the acupuncture group, the massage group and the control group (oral administrated with Somiton tablet). The treatment course was 3 menstrual cycles. The effect in relieving menalgia was evaluated using numerical rating scale (NRS) before and after treatment and change of PGF2alpha content in menstrual fluid was tested as well.. The NRS score was 0.60 +/- 0.67 in the acupuncture group and 0.53 +/- 0.63 in the massage group respectively, significantly lower than that in the control group, which was 2.30 +/- 1.73 (P < 0.01). The PGF2alpha level after treatment was significantly lower in the acupuncture group (176.58 +/- 17.85 ng/L) and the massage group (171.32 +/- 17.15 ng/L) than that in the control group (220.56 +/- 54.47 ng/L), respectively (P <0.01). There showed no difference in the two aspects between the acupuncture group and the massage group (P >0.05).. Acupuncture and massage has a reliable therapeutic effect on primary dysmenorrhea, which is superior to that of Somiton tablet, and its mechanism might be exerted by regulating PGF2alpha level in menstrual fluid.

Topics: Acupuncture Therapy; Decidua; Dinoprost; Dysmenorrhea; Female; Humans; Massage

To observe the therapeutic effect of acupuncture at Siguan points with Qinglong Baizei method on primary dysmenorrhea (PD) and to study the mechanism.. One hundred and eighty cases of PD were zandomly divided into group A, group B and group C, 60 cases in each group. Group A were treated by acupuncture at Hegu (LI 4) and Taichong (LR 3) with Qinglong Baiwei method; group B were treated by routine acupuncture with Sanyinjiao (SP 6), Ciliao (BL 32) selected as main points; and group C were treated by oral administration of Yueyueshu Decoction. After treatment of 3 months, the therapeutic effects were analyzed, and changes of hemorrheological indexes and prostaglandin level were observed.. The cured rate and the total effective rate were 75.0% and 100.0% in group A, 60.0% and 95.0% in group B, and 25.0% and 90.0% in group C, respec tively, group A and B being significantly better than group C (P < 0.01). And the analgesic effects within 30 min of treatment in both group A and group B were significantly better than that in group C (P < 0.01), and that in group A was significantly better than that in group B (P < 0.01).. Acupuncture at Siguan points with Qinglong Baiwei method has a significant therapeutic effect on primary dysmenorrhea. The possible mechanism is to relieve pain by improving blood circulation and inhibiting production of prostaglandin.

Topics: Acupuncture Points; Acupuncture Therapy; Adolescent; Adult; Dinoprost; Dysmenorrhea; Female; Humans; Medicine, Chinese Traditional

The purpose of this study was to compare acetaminophen with ibuprofen for pain relief and menstrual fluid prostaglandin F2alpha (PGF2alpha) suppression in primary dysmenorrhea.. Twelve subjects were randomized to placebo, acetaminophen (1000 mg orally, 4 x daily for 3 days) or ibuprofen (400 mg orally, 4 x daily for 3 days), once during each cycle in a prospective, double-blinded, crossover study. Using preweighed super absorbent tampons, menstrual fluid was collected, extracted, and PGF2alpha radioimmunoassayed.. Ten patients completed the study. Ibuprofen (P = .002) and acetaminophen (P = .022) were rated significantly better than placebo. Total menstrual fluid PGF2alpha with placebo was 36.2 + 6.1 microg but were 14.8 + 3.0 microg with ibuprofen (P = .001) and 21.4 + 3.4 microg with acetaminophen (P = .008). PGF2alpha concentrations with placebo were 0.34 + 0.054 microg/mL, with ibuprofen 0.16 + 0.026 microg/mL (P = .001), and with acetaminophen 0.23 + 0.029 microg/mL (P = .016).. Both ibuprofen and acetaminophen were superior to placebo for pain relief and menstrual fluid PGF2alpha suppression, with ibuprofen being more potent.

Topics: Acetaminophen; Adult; Analgesics, Non-Narcotic; Body Fluids; Cross-Over Studies; Dinoprost; Double-Blind Method; Dysmenorrhea; Female; Humans; Ibuprofen; Menstruation; Prospective Studies

Eleven women with primary dysmenorrhea completed a randomized, double-blind, placebo-controlled, three-way cross-over study comparing 200 and 400mg suprofen. Menstrual fluid volume did not change. Mean+/-S.E.M. menstrual fluid PGF2a was significantly suppressed from 18.9+/-1.9 microg (placebo) to 10.9+/-1.7 and 9.3+/-2.1 microg with 200 and 400 mg suprofen, respectively (p=<0.005). PGE2 dropped from 7.8+/-0.9 to 4.6+/-0.8 and 4.6+/-1.1 microg (p=<0.05) and TxB2 from 17.5+/-4.3 to 7.5+/-2.9 and 3.6+/-1.3 microg (p=<0.01), respectively. 6-Keto PGF1a was significantly suppressed (2.7+/-0.4 to 1.9+/-0.5 microg, p=<0.025) with only 400 mg suprofen. Six subjects rated placebo poor and five fair to very good. In contrast, nine rated suprofen excellent to fair while two rated poor. Thus, suprofen was clinically effective but the differential suppression of prostanoids favors 200mg which spares 6-keto PGF1a.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Anti-Inflammatory Agents, Non-Steroidal; Body Fluids; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Humans; Menstruation; Prostaglandins; Suprofen; Thromboxane B2

Topics: Adult; Capsules; Dinoprost; Drugs, Chinese Herbal; Dysmenorrhea; Female; Hemorheology; Humans; Phytotherapy

We compared menstrual pain, uterine contractility and blood circulation, and plasma concentrations of vasopressin and prostaglandin F(2alpha) metabolite in women with versus without primary dysmenorrhea, and determined the effects of a vasopressin antagonist, 1-deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-oxytocin (Atosiban), on these parameters. Our results do not support the contention that vasopressin is involved in the etiology of dysmenorrhea, plasma concentrations of vasopressin being similar in dysmenorrheic women and controls, and the vasopressin antagonist Atosiban having no effect on menstrual pain, intrauterine pressure or uterine artery pulsatility index in dysmenorrheic women.

Topics: Adult; Blood Flow Velocity; Cross-Over Studies; Dinoprost; Double-Blind Method; Dysmenorrhea; Female; Hormone Antagonists; Humans; Uterine Contraction; Uterus; Vasopressins; Vasotocin

Non-drug therapies for women with primary dysmenorrhea are primarily based on anecdotal evidence and small-scale clinical studies. This randomized, observer-blinded, clinical trial evaluated the efficacy of spinal manipulative therapy (SMT) in the treatment of women with primary dysmenorrhea. Women were recruited from the Chicago metropolitan area and evaluated for inclusion through four screening levels. One hundred thirty eight women, ages 18-45, with primary dysmenorrhea diagnosed by participating gynecologists, were randomly assigned to either SMT or a low-force mimic (LFM) maneuver. No treatment occurred at menstrual cycle 1. Treatment for both groups took place on day 1 of cycles 2, 3 and 4, and prophylactic treatment of three visits took place during the 7 days before cycles 3 and 4. Main outcome measures were the Visual Analog Scale (VAS) and plasma concentration of the prostaglandin F2alpha metabolite, 15-keto-13,14-dihydro-prostaglandin F2alpha (KDPGF2alpha), measured 15 min before treatment and 60 min after treatment on day 1 of four consecutive menstrual cycles. The Moos' Menstrual Distress Questionnaire (MDQ) was also administered after treatment on day 1 of each cycle. At cycle 2, the post-treatment VAS scores decreased for both groups, with no statistically significant difference in pre- to post-treatment scores between the two groups (P = 0.44). The changes in pre- to post-treatment KDPGF2alpha levels were not statistically different between the SMT and LFM groups (P = 0.15). No treatment effects were detected over the three cycles for VAS, KDPGF2alpha or MDQ (P = 0.65, P = 0.61 and P = 0.78, respectively). However, there were statistically significant linear time effects for VAS (P = 0.008), MDQ (P < 0.001), and borderline significance for KDPGF2alpha (P = 0.054); these decreases were not considered clinically meaningful. The LFM maneuver used in this study was designed to act as a 'placebo-like' control treatment in comparison with SMT. Although it is possible that the trial did not continue long enough for any placebo effect of the LFM to wash out, it seems more likely that this maneuver was indistinguishable from SMT. Therefore, the postulated superior benefit of high-velocity, short-lever, low-amplitude, high-force spinal manipulation to a low-force maneuver is not supported by the results of this study. 1999 International Association for the Study of Pain.

Topics: Adolescent; Adult; Dinoprost; Dysmenorrhea; Female; Humans; Manipulation, Spinal; Middle Aged; Pain Measurement; Posture; Single-Blind Method; Surveys and Questionnaires; Treatment Outcome

The relationship between menstrual and bowel symptoms, the overlap between the diagnoses of dysmenorrhea (DYS) and functional bowel disorder (FBD), and markers that may be useful in discriminating functional bowel disorders from DYS were studied in 383 women (20-40 yr of age).. All women completed the NEO Personality Inventory at intake and completed the Moos' Menstrual Distress Questionnaire and a bowel symptom inventory every 3 months for 12 months. Prostaglandin levels were measured in vaginal dialysate on the first day of menses.. DYS was diagnosed in 19.8% of the total sample. Functional bowel disorder, defined as abdominal pain with altered bowel function, was diagnosed in 61% of the DYS group compared with 20% of controls (p < 0.05). Neuroticism scores were significantly higher in subjects with functional bowel disorder with or without DYS. However, bowel symptoms were significantly correlated with menstrual symptoms even after statistically controlling for the effects of neuroticism. Painful menses and water retention distinguished the DYS group from the functional bowel disorder group. Prostaglandin levels were elevated in women with DYS, but did not consistently differentiate the diagnostic groups.. The strong covariation of menstrual and bowel symptoms, along with the overlap in diagnoses of DYS and function bowel disorder, suggest a common physiological basis.

Topics: Adult; Colonic Diseases, Functional; Diagnosis, Differential; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Humans; Neurotic Disorders; Pain Measurement; Personality Inventory

The relationship between prostaglandins (PGs) production and the mechanism of dysmenorrhea in endometriosis is poorly understood. Consequently, we investigated the role of PGs in dysmenorrhea of endometriosis. Slices of normal endometrium, normal myometrium, adenomyosis, leiomyoma, normal ovary and affected ovary were incubated. 6-keto PGF1 alpha (a metabolite of PGI2), TXB2 (a metabolite of TXA2), PGF2 alpha and PGE2 concentrations of the incubation medium were measured by RIA. The results are as follows; 1) PGs production in endometriosis was significantly higher than that of other tissues, especially 6-keto PGF1 alpha, which was a dominant product in adenomyosis. 2) There were significant differences in PGs production between severe dysmenorrhea and non dysmenorrhea, especially tissue of adenomyosis with severe dysmenorrhea which produces large amounts of 6-keto PGF1 alpha. 3) There seems to be interaction between normal endometrium and normal myometrium with regard to 6-keto PGF1 alpha production. We concluded that increased PGI2 in the tissue of endometriosis seems to induce hyperalgesia during menstruation.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Endometriosis; Endometrium; Epoprostenol; Female; Humans; Hyperalgesia; Myometrium; Ovarian Diseases; Ovary; Prostaglandins; Thromboxane B2

The primary objectives of this study were to compare the effect of spinal manipulation vs. sham manipulation on a) circulating plasma levels of the prostaglandin F2a metabolite, 15-keto-13,14-dihydroprostaglandin (KDPGF2a), b) perceived abdominal and back pain and c) perceived menstrual distress in women with primary dysmenorrhea.. This randomized clinical pilot study investigated the outcome measures before and after either a spinal manipulation treatment (SMT) or a sham manipulation.. All subjects were treated at the National College Chiropractic clinic, a private chiropractic clinic in the suburban Chicago area.. Forty-five women with a history of primary dysmenorrhea were recruited from the local community. The volunteers ranged in age from 20-49 (mean age = 30.3 yr), and were entered into the study between April 1990 and January 1991. Twenty-four were randomly assigned to the spinal manipulation group and 21 were assigned to the sham group.. Subjects treated with spinal manipulation were placed in a side-lying position with the bottom leg straight and the top leg flexed at the knee and hip. They received a high-velocity, short lever, low-amplitude thrust to all clinically relevant vertebral levels within T10 and L5-S1 and the sacroiliac joints. In the sham manipulation, subjects were placed in a side-lying position with both hips and knees flexed. Their manipulation consisted of a similar thrust administered to the midline base of the sacrum.. Perceived abdominal and back pain were measured with a visual analog scale, and menstrual distress was measured with the Menstrual Distress Questionnaire. Both were administered 15 min before and 60 min after treatment. Blood samples were collected by venipuncture for the determination of plasma levels of KDPGF2a at the same times. The plasma was then assayed for KDPGF2a by radioimmunoassay.. Analysis of covariance and paired Student's t tests were used for the statistical evaluation. Immediately after treatment, the perception of pain and the level of menstrual distress were significantly reduced by SMT. This reduction was associated with a significant reduction in plasma levels of KDGPF2a in the SMT group. A significant and similar reduction in plasma KDPGF2a also occurred in the sham group, indicating that a placebo effect was associated with a single sham intervention.. This randomized pilot study suggests that SMT may be an effective and safe nonpharmacological alternative for relieving the pain and distress of primary dysmenorrhea. However, the large change in KDPGF2a observed in both treatment groups clearly indicates that further studies with more subjects, studied over a longer time frame, are needed to resolve the question of a placebo effect.

Topics: Abdominal Pain; Adult; Back Pain; Chiropractic; Dinoprost; Dysmenorrhea; Female; Humans; Manipulation, Orthopedic; Middle Aged; Pilot Projects; Spine

50 patients suffering from primary dysmenorrhoea were treated with Magnesium (Mg 5-longoral, Artesan GmbH) in a double-blind study. After a six-month period 21 out of 25 women showed a decline of symptoms, only 4 ones reported no therapeutical effect. For monitoring treatment results prostaglandin F2 alpha (PGF2 alpha) was measured every second month. On Mg-therapy conditions we achieved a reduction of PGF2 alpha in menstrual blood to 45% of value before treatment started. As against that 90% of basic concentration were estimated from women who received a placebo. Probably, the specific therapeutical effect of Mg based on inhibition of biosynthesis of PGF2 alpha but also on its direct muscle relaxant and vasodilatory effect. Beside the PG-synthesis and ovulation inhibitors the use of Magnesium is a potential, natural opportunity to treat primary dysmenorrhoea, which is widely free of side effects.

Topics: Adolescent; Adult; Aspartic Acid; Clinical Trials as Topic; Dinoprost; Double-Blind Method; Dysmenorrhea; Female; Humans; Magnesium

Topics: Adolescent; Adult; Clinical Trials as Topic; Dinoprost; Dinoprostone; Dose-Response Relationship, Drug; Double-Blind Method; Dysmenorrhea; Female; Humans; Ketoprofen; Phenylpropionates; Prostaglandins E; Prostaglandins F

Following the demonstration that increased prostaglandin F2 alpha production causes pain similar to dysmenorrhea, and the finding that prostaglandin synthetase inhibitors are capable of relieving menstrual pain, the early theory of uterine ischemia has once again gained support as the most likely explanation for this condition. In a double-blind, placebo-controlled, crossover study, 30 of 43 women with moderate to severe dysmenorrhea who completed the trial preferred flurbiprofen (Ansaid, Upjohn), a potent new analgesic/anti-inflammatory agent (50 mg four times daily), to aspirin (650 mg four times daily) and placebo. Flurbiprofen was also rated superior to aspirin and placebo in the degree of pain relief. An algorithm for the diagnosis and treatment of 90 percent of women with primary dysmenorrhea is presented.

Topics: Adolescent; Adult; Aspirin; Dinoprost; Dysmenorrhea; Female; Flurbiprofen; Humans; Middle Aged; Pain; Propionates; Prostaglandins F

Prostaglandins E2 and F2 alpha in the menstrual fluid from 12 patients with primary dysmenorrhea were measured by radioimmunoassay (RIA). Each patient was studied for 3 cycles, using vaginal tampons issued for this study. All tampons were collected individually for prostaglandin extraction and RIA. Severity of dysmenorrhea and clinical response to treatment were evaluated by a scoring method and by the patients' self-assessment. Each patient in this double-blind cross-over study had a control cycle and 2 treatment cycles with naproxen sodium tablets (275 mg) or placebo in random order. The treatment regimen was 2 tablets at the first sign of menses followed by one tablet 4 times daily for 3 days. Nine patients obtained good to excellent relief from naproxen sodium, but no relief from the placebo. Two patients had moderate to good response to both naproxen and placebo, and one patient showed no response. Naproxen therapy but not placebo therapy sharply reduced menstrual prostaglandin F2 alpha and prostaglandin E2 release. There was a positive correlation between menstrual prostaglandin levels and the severity of dysmenorrhea. Symptomatically, naproxen sodium was most effective in alleviating severe menstrual cramps but had little effect on mild cramps. It was also effective in ameliorating many but not all of the subjective symptoms such as dizziness, nausea, and vomiting. Relief of dysmenorrhea was apparent within one hour after the initial dose, attained maximum level in 2 hours, and was maintained throughout therapy.

Topics: Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Humans; Menstruation; Naproxen; Prostaglandins E; Prostaglandins F

To investigate the mechanism of electroacupuncture(EA) intervention in rats with primary dysmenorrhea(PDM) based on the Toll-like receptor 4(TLR4)/nuclear factor(NF)-κB signaling pathway.. Forty female SD rats were randomly divided into blank control, model, EA and medication groups, with 10 rats in each group. PDM rat model was established by subcutaneous injection of estradiol benzoate combined with intraperitoneal injection of oxytocin. At the same time of model procedures, EA(50 Hz, dense wave) was applied to "Guanyuan" (CV4) and bilateral "Sanyinjiao" (SP6) of rats in the EA group, with needles retained for 20 min, for 10 consecutive days. Rats in the medication group received ibuprofen(125 mg/100 mL, 0.8 mL) by gavage for 10 consecutive days. At the 11th day, writhing behavior of rats was assessed. Uterine morphology was observed by eyes and uterine pathological changes were observed after HE staining. Content of prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) in serum and uterine tissues was detected by ELISA; NF-κB p65 positive expression in nucleus was detected by immunofluorescence; protein expression levels of TLR4, NF-κB p65, p-NF-κB p65 and inflammatory factors interleukin (IL) -1β and IL-18 were detected by Western blot.. After modeling, uterus tissues were congested and edematous, with necrosis of luminal epithelium, severe edema and extensive shedding of endometrium, nuclear pyknosis, fragmentation and disappearance, neutrophils infiltration, and slight expansion of glandular cavity, which was milder in the EA and the medication groups. Compared with the blank control group, writhing times, scores and incubation period, HE pathological scores, PGF2α contents in serum and uterine tissues, ratio of NF-κB p65 positive expression in nucleus, TLR4, NF-κB p65, p-NF-κB p65, IL-1β and IL-18 protein expression levels in uterine tissues of rats in the model group were all significantly increased(. EA intervention could relieve inflammatory response and pain in PDM rats, which may be related to its effect in reducing TLR4 expression, inhibiting NF-κB activation and down-regulating inflammatory factors levels of IL-1β and IL-18.

Topics: Animals; Dinoprost; Dinoprostone; Dysmenorrhea; Electroacupuncture; Female; Inflammation; Interleukin-18; NF-kappa B; Rats; Rats, Sprague-Dawley; Signal Transduction; Toll-Like Receptor 4

Akebiae Fructus, a Tujia minority folk medicine and a well-known traditional Chinese medicine for soothing the liver, regulating Qi, promoting blood circulation and relieving pain, is widely used in the treatment of primary dysmenorrhea. However, little is known about its underlying mechanism.. To explore the effect of Akebiae Fructus on primary dysmenorrhea model induced by estradiol benzoate and oxytocin, and to provide better understanding of the mechanism of Akebiae Fructus for primary dysmenorrhea treatment.. The primary dysmenorrhea mouse model was used in this study. Except for the control group and the normal administration group, the mice of other groups were subcutaneously injected with estradiol benzoate (10 mg/kg/d) for 10 consecutive days. From the 5th day of the ten-day model period, the positive control groups were given 0.075 g/kg ibuprofen and 7.5 g/kg Leonurus granule, the drug groups were given 0.2 g/kg, 0.4 g/kg, 0.8 g/kg Akebiae Fructus extract, the normal administration group was given 0.8 g/kg Akebiae Fructus extract, and the same volume saline was given in the control group. On the tenth day, oxytocin (10 U/kg) was peritoneally injected after estradiol benzoate injected 1 h. After the oxytocin injection, writhing behavior was observed for 30 min. Then the uterine tissue was collected to measure the level of PGF. Akebiae Fructus inhibited the writhing, decreased the PGF. Akebiae Fructus could effectively alleviate the symptoms of primary dysmenorrhea, regulate metabolic disorders, and control the related gene expression in primary dysmenorrhea. The study may provide clues for further study of Akebiae Fructus treatment on primary dysmenorrhea.

Topics: Animals; Benzoates; Biomarkers; Dinoprost; Dinoprostone; Disease Models, Animal; Drugs, Chinese Herbal; Dysmenorrhea; Female; Gene Expression Regulation; Inflammation; Medicine, Chinese Traditional; Metabolic Networks and Pathways; Metabolome; Mice, Inbred ICR; Oxytocin; Pain; Ranunculales; Transcriptome; Uterine Contraction; Uterus

Curcumae Rhizoma (CR) has a clinical efficacy in activating blood circulation to dissipate blood stasis and has been used for the clinical treatment of qi stagnation and blood stasis (QSBS) primary dysmenorrhea for many years. However, its molecular mechanism is unknown.. The present study aimed to demonstrate the multicomponent, multitarget and multipathway regulatory molecular mechanisms of CR in the treatment of QSBS primary dysmenorrhea.. Observations of pathological changes in uterine tissues and biochemical assays were used to confirm that a rat model was successfully established and that CR was effective in the treatment of QSBS primary dysmenorrhea. The main active components of CR in rat plasma were identified and screened by ultra-performance liquid chromatography-quadrupole/time-of-flight mass spectrometry (UPLC-Q/TOF-MS). The component-target-disease network and protein-protein interaction (PPI) network of CR were constructed by a network pharmacology approach. Then, we performed Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Molecular docking was adopted to verify the interactions between the core components and targets of CR to confirm the accuracy of the network pharmacology prediction results. Furthermore, we evaluated the bioactive constituents of CR and molecular mechanism of by which CR promote blood circulation and remove blood stasis via platelet tests in vivo and in vitro and Western blot analysis.. The results of HE staining and biochemical assays of PGF2α, TXB2 and Ca. This study demonstrated the bioactive constituents and mechanisms of CR in promoting blood circulation and removing blood stasis and its multicomponent, multitarget and multipathway treatment characteristics in primary dysmenorrhea. The results provide theoretical evidence for the development and utilization of CR.

Topics: Animals; Calcium; Chromatography, High Pressure Liquid; Dinoprost; Disease Models, Animal; Drugs, Chinese Herbal; Dysmenorrhea; Female; Humans; Molecular Docking Simulation; Phosphatidylinositol 3-Kinases; Platelet Aggregation; Protein Interaction Maps; Rats, Sprague-Dawley; Signal Transduction; Uterus

Several studies have evaluated the effects of high-intensity aerobic training (HIAT) on pain severity and quality of life (QoL) among women with primary dysmenorrhea. However, to date, no studies have evaluated the effectiveness of HIAT on academic performance or absenteeism or examined the cost-effectiveness of HIAT relative to other treatments in women with primary dysmenorrhea. Furthermore, the mechanisms underlying aerobic exercise-induced analgesia in primary dysmenorrhea remain unclear. The objectives of this study are to: (1) evaluate the effects of HIAT on absenteeism and academic performance among university students, (2) identify the underlying mechanisms associated with aerobic exercise-induced analgesia in primary dysmenorrhea, and (3) determine the cost-effectiveness of HIAT compared with a wait-list control (WLC) group receiving usual care.. A sequential, embedded, mixed-methods study design, including a crossover, randomised controlled trial (RCT) and semi-structured focus groups, will be conducted alongside an economic evaluation. A total of 130 women aged 18-24 years will be randomised into either HIAT (n = 65) or wait-list control (n = 65) groups. Primary outcomes will include average pain intensity, absenteeism from university, and academic performance. Primary mediators will include salivary progesterone and prostaglandin F2α levels. Outcome and meditator variables will be assessed at baseline and post-treatment, at 12 and 28 weeks. An economic analysis will be conducted from the societal and healthcare perspective of Hong Kong. Semi-structured focus groups will be conducted at 32 weeks. Of the 130 participants included in the RCT, 70 will be included in the focus groups.. All statistical analyses will be performed on an intention-to-treat basis, using SPSS (version 24). Preliminary analysis using an independent samples t-test and a two-sided, unpaired Student's t-test will be performed to exclude carryover effects and identify within-participant differences in outcome variables between the study periods, respectively. Treatment effects will be evaluated using analysis of variance via a mixed-effects model with fixed effects for intervention, period, and sequence. In all models, random effects will include the participants nested within the sequence as a sampling cluster. The mediation effects will be assessed using the Sobel test. The EQ-5D responses will be converted into utility scores to estimate the gain or loss of quality-adjusted life-years. Seemingly unrelated regression analyses will be used to estimate the total cost differences and effect differences. Qualitative data will be analysed using the process of thematic analysis.

Topics: Absenteeism; Academic Performance; Adolescent; Cost-Benefit Analysis; Cross-Over Studies; Dinoprost; Dysmenorrhea; Exercise; Feasibility Studies; Female; Focus Groups; Humans; Pain; Progesterone; Quality of Life; Quality-Adjusted Life Years; Randomized Controlled Trials as Topic; Students; Universities; Young Adult

Primary dysmenorrhea (PD) is one of the common gynecological diseases, the incidence of PD is on the rise and young women are more likely to have it, which seriously affects women's physical, mental health and work life. Intradermal acupuncture is effective in treating PD. However, due to the lack of evidence, there is no specific method or suggestion, so it is necessary to carry out systematic evaluation on intradermal acupuncture and provide effective evidence for further research.. We will search the following electronic databases from their inception to July 2020: Electronic database includes PubMed, Embase, Cochrane Library, Chinese Biomedical Database WangFang, VIP medicine information, and CNKI (China National Knowledge Infrastructure). Primary outcomes: the overall effective rate, VAS score.. blood serum estradiol (E2), progesterone (P), prostaglandin F2α (PGF-2α), adverse events Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0.. The results of this study will systematically evaluate the effectiveness and safety of intradermal acupuncture in the treatment of primary dysmenorrhea.. The systematic review of this study will summarize the currently published evidence of intradermal acupuncture therapy for primary dysmenorrhea to further guide its promotion and application.

Topics: Acupuncture Therapy; Dinoprost; Dysmenorrhea; Estradiol; Female; Humans; Meta-Analysis as Topic; Progesterone; Randomized Controlled Trials as Topic; Research Design; Systematic Review as Topic

Primary dysmenorrhea is a common occurrence in adolescent women and is a type of chronic inflammation. Dysmenorrhea is due to an increase in oxidative stress, which increases cyclooxygenase-2 (COX-2) expression, increases the concentration of prostaglandin F2α (PGF2α), and increases the calcium concentration in uterine smooth muscle, causing excessive uterine contractions and pain. The polyphenolic compound oleocanthal (OC) in extra virgin olive oil (EVOO) has been shown to have an anti-inflammatory and antioxidant effect. This study aimed to investigate the inhibitory effect of extra virgin olive oil and its active ingredient oleocanthal (OC) on prostaglandin-induced uterine hyper-contraction, its antioxidant ability, and related mechanisms. We used force-displacement transducers to calculate uterine contraction in an ex vivo study. To analyze the analgesic effect, in an in vivo study, we used an acetic acid/oxytocin-induced mice writhing model and determined uterus contraction-related signaling protein expression. The active compound OC inhibited calcium/PGF2α-induced uterine hyper-contraction. In the acetic acid and oxytocin-induced mice writhing model, the intervention of the EVOO acetonitrile layer extraction inhibited pain by inhibiting oxidative stress and the phosphorylation of the protein kinase C (PKC)/extracellular signal-regulated kinases (ERK)/ myosin light chain (MLC) signaling pathway. These findings supported the idea that EVOO and its active ingredient, OC, can effectively decrease oxidative stress and PGF2α-induced uterine hyper-contraction, representing a further treatment for dysmenorrhea.

Topics: Abdominal Pain; Aldehydes; Animals; Anti-Inflammatory Agents; Antioxidants; Calcium; Cyclooxygenase 2; Cyclopentane Monoterpenes; Dinoprost; Disease Models, Animal; Dysmenorrhea; Female; Mice; Olive Oil; Oxidative Stress; Oxytocin; Phenols; Prostaglandins; Signal Transduction; Uterine Contraction; Uterus

The popular accepted explanation for the pathogenesis of primary dysmenorrhea is elevated levels of uterine prostaglandins. Aetiological studies report that production of prostaglandins is controlled by the sex hormone progesterone, with prostaglandins and progesterone displaying an inverse relationship (i.e. increased progesterone levels reduce prostaglandin levels). Pro-inflammatory cytokines (interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-α]) are also implicated in the pathogenesis of primary dysmenorrhea. High-intensity aerobic exercise is effective for decreasing pain quality and intensity in women with primary dysmenorrhea. However, why and how aerobic exercise is effective for treatment of primary dysmenorrhea remain unclear. Our preliminary non-randomized controlled pilot study to examine the effects of high-intensity aerobic exercise on progesterone, prostaglandin metabolite (13,14-dihydro-15-keto-prostaglandin F2 alpha (KDPGF

Topics: Cytokines; Dinoprost; Dysmenorrhea; Exercise; Female; Hormones; Humans; Inflammation; Pain Management; Pilot Projects; Progesterone; Prostaglandins; Uterus

Objective To observe the roles of Fufang Shixiao Formula (FFSXF) in regulating prostaglandin E₂ (PGE₂) , prostaglandin F₂ alpha (PGF₂α) , and β-endorphin. peptide (β-EP) in rats with primary dysmenorrhea, and to explore its mechanisms for treating primary dysmenorrhea. Methods Primary dysmenorrheal rat model was induced by Estradiol Benzoate combined oxytocin. Indomethacin and Yueyueshu were used as the controls. 2. 5, 5. 0, and 10. 0 g/kg FFSXF (clinical commonly used dose of FFSXF calculated by converting human weight to rat weight) suspensions were administered to rats in low, middle, high dose FFSXF groups, respectively. Changes of PGE₂ and PGF₂α. in uterus tissue were observed by ELISA. Its effect on β-EP in peripheral blood was observed by radioimmunoassay. Results Compared with the model group, PGE₂ content significantly increased (P <0.01) , and PGF₂α. content significantly decreased in the 3 FFSXF groups (P <0. 05, P <0. 01) , and β-EP content significantly increased (P <0. 01) in middle and high dose FFSXF groups. Conclusion FFSXF could effectively regulate prostaglandin level in uterus tissue of primary dysmenorrheal model rats, elevate β-EP content in peripheral blood, strengthen endogenous analgesic effects, which might be its mechanisms for treating primary dysmenorrhea.

Topics: Animals; beta-Endorphin; Dinoprost; Dinoprostone; Drugs, Chinese Herbal; Dysmenorrhea; Female; Rats; Uterus

Guizhi Fuling formula, a well-known Chinese herbal formula recorded in the Eastern Han Dynasty, is composed of Cinnamomum cassia (L.) J.Presl (Cassia bark), Poria cocos (Schw.) Wolf (Poria), Paeonia suffruticosa andrews (Moutan Cortex), Paeonia lactiflora Pall (Herbaceous peony), and Amygdalus persica L.(Persicae Semen). It has clinical efficacy of activating blood circulation to dissipate blood stasis and is commonly used for the treatment of primary dysmenorrhea. However, its therapeutic mechanism has not been clearly elucidated. The aim of this study is to reveal molecular mechanisms of action using in vivo and in vitro experimental models.. The ICR mouse uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment. Mice were given GZFLC (0.54, 1.08g/kg) by gavage. The levels of NO, PGF2α and Ca(2+) in uterine tissue were determined according to instructions. Cyclooxygenase-2 (COX-2) and oxytocin receptor (OTR) proteins in uterine tissue were assessed by Western Blot. Mouse isolated uterus strips were mounted in tissue organ baths containing Locke's solution. The contractile responses were recorded with Power Lab recording system. The effect of GZFLC on spontaneous uterine contraction, and uterine contraction induced by oxytocin, PGF2α was observed. Myometrial cells were exposed to oxytocin (5U/L) to induce calcium release, and the effect of GZFLC and its components (PL, PGG, CA) on intracellular Ca(2+) was analyzed with fluorometry imaging.. In vivo study demonstrated that GZFLC significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 55%. It also decreased the levels of NO, PGF2α and Ca(2+) in oxytocin-induced mice uterine tissue. Moreover, Western blot analysis showed that COX-2 and OTR expressions in uterine tissue of dysmenorrhea mice were significantly reduced. GZFLC inhibited spontaneous uterus contractions in a dose-dependent manner, and the IC50 value was 0.99mg/ml. The IC50 values of GZFLC on PGF2α, oxytocin-induced contractions were 1.45mg/ml, 3.53mg/ml, respectively. Further in vitro studies indicated that GZFLC and its components (PL, PGG, CA) could restrain intracellular calcium levels in favour of uteri relaxation.. Both in vivo and in vitro results indicated that GZFLC possessed a significant spasmolytic effect on uterine tetanic contraction. The present study provides in vivo and in vitro experimental evidence to support the use of GZFLC for the clinical treatment of primary dysmenorrheal (PD).

Topics: Animals; Calcium; Cyclooxygenase 2; Dinoprost; Dose-Response Relationship, Drug; Drugs, Chinese Herbal; Dysmenorrhea; Estradiol; Female; In Vitro Techniques; Mice, Inbred ICR; Nitric Oxide; Oxytocics; Oxytocin; Parasympatholytics; Receptors, Oxytocin; Tocolytic Agents; Uterine Contraction; Uterus

Primary dysmenorrhea (PD) is a common gynecological disorder. Hitherto, animal models which recapitulate clinical features of PD have not been fully established. We aimed to examine whether a pain model in mice could mimic the clinic features of PD. After pretreated with estradiol benzoate (1 mg/kg/day) intraperitoneally (i.p.) for 3 consecutive days, non-pregnant female Imprinting Control Region mice (6-8 weeks old) was injected with 0.4 U of oxytocin to induce the stretching or writhing response which was recorded for a time period of 30 min. During the writhing period, the uterine artery blood flow alterations were examined by Doppler ultrasound detection. After writhing test, the uterine morphological changes were observed by hematoxylin and eosin (H&E) staining histopathology. In addition, enzyme-linked immunosorbent assay kit was used to measure the levels of prostaglandins F2α/prostaglandins E2 (PGF2α/PGE2) and TXB2 (a metabolite of TXA2)/6-keto-PGF1α (a metabolite of PGI2) in the uterine tissue homogenates and plasma, respectively. Western blot analyses were performed to determine the expressions of oxytocin receptor (OTR), beta2-adrenergic receptor (beta2-AR), and cyclooxygenase-2 (COX-2) in uterine, which are responsible for the uterine contraction. The writhing response only occurred in the estrogen pretreated female mice. The area of uterine myometrium significantly decreased along with the increased thickness in the oxytocin-induced estrogen pretreated mice model. The uterine artery blood flow velocity dropped, while the pulsatility index and resistance index slightly increased after the injection of oxytocin. The PGF2α/PGE2 level significantly increased and the plasma TXB2/6-keto-PGF1α level significantly enhanced. Compared with the control group, the uterine histopathology demonstrated moderate to severe edema of endometrium lamina propria. In consistent with the uterine morphological changes, a significant reduction of beta2-AR and a significant increase of OTR and COX-2 in the uterine tissue were observed. The writhing response was caused by the abnormal contraction of uterus. The uterine spasm and ischemia changes of oxytocin-induced estrogen pretreated female mice model were similar to the pathology of human PD. We reported an in vivo mice model, which can be used to study PD and for clinical therapeutic evaluations.

Topics: Animals; Blood Flow Velocity; Cyclooxygenase 2; Dinoprost; Dinoprostone; Disease Models, Animal; Dysmenorrhea; Female; Ischemia; Male; Mice, Inbred ICR; Myometrium; Receptors, Adrenergic, beta-2; Receptors, Oxytocin; Uterine Artery; Uterine Contraction; Uterus

In 2012, the preparation process and quality standard for Guizhi Fuling capsule were improved. To compare the effects and differences of capsules before (2011) and after(2012-2014) the improvement, evaluation models for intrinsic dysmenorrhea, pelvic inflammation and hysteromyoma were applied in rats. Models were induced by oxytocin, liqiud bacteria mixture and estrogen loading, respectively. The capsules (12 batchs/year, 48 bathcs in all), sampled randomly in 2011-2014, the effects were assessed using the three models. In anti-dysmenorrhea models, remarked reduction of writhing frequency, ET-1 and PGF2α content in uterus could be detected, as well as extension of writhing latency. In pelvic inflammation rats, depression of TNF-α and raise of IL-2 were induced by earh batch of capsules. In hysteromyoma model, uterine weight and smooth muscle proliferation, including E2 and P level in plasma, were lowered obviously by all batchs of capsules. Secondly, Guizhi Fuling capsules produced in 2012-2014 revealed better effectiveness than the ones manufactured in 2011. Moreover, pharmacodynamics indexes of the samples made in 2011 differed significantly between groups, which could not be observed in the ones ot 2012-2014. After tne preparation process and quality standard improvement, the effectiveness and homogeneity of Guizhi Fuling capsules were enhanced.

Topics: Animals; Capsules; Depression; Dinoprost; Drugs, Chinese Herbal; Dysmenorrhea; Female; Humans; Interleukin-2; Pelvic Inflammatory Disease; Quality Improvement; Rats; Rats, Sprague-Dawley; Tumor Necrosis Factor-alpha

To elucidate the mode of action of chlormadinone acetate (CMA) in reducing dysmenorrheic pain by studying the effects of CMA and dexamethasone (DEX) on messenger RNA (mRNA) abundance of cyclo-oxygenase-2 (COX-2), annexin-1 (ANXA1), glucocorticoid receptor (GR), progesterone receptor (PR), and concentrations of prostaglandin F(2α) (PGF(2α)) and leukotrienes B(4) (LTB(4)) and C(4) (LTC(4)) in human endometrial explants.. Ex vivo study.. University hospital.. Fifteen premenopausal patients undergoing surgery for benign gynecologic disorders.. Endometrial explants were obtained by aspiration curettage and stimulated ex vivo with interleukin-1β before exposure to CMA or DEX; mRNA levels were determined via reverse transcription-quantitative real-time polymerase chain reaction, and concentrations of arachidonic acid metabolites by enzyme immunoassays.. Messenger RNA levels of COX-2, ANXA1, PR, and GR; concentrations of PGF(2α), LTB(4), and LTC(4) in endometrial explants treated with CMA or DEX.. In IL-1β-treated explants COX-2 mRNA and PGF(2α), concentrations were significantly down-regulated by CMA but not by DEX. Chlormadinone acetate did not affect mRNA abundance of ANXA1, PR, and GR.. Our data suggest that CMA is a suppressor of COX-2 expression. Comparison with DEX revealed that progestin-specific activity of CMA may mainly be responsible for suppression of prostaglandin biosynthesis in human endometrium.

Topics: Adolescent; Adult; Annexin A1; Chlormadinone Acetate; Contraceptives, Oral, Synthetic; Cyclooxygenase 2; Dexamethasone; Dinoprost; Dysmenorrhea; Endometrium; Female; Glucocorticoids; Humans; Interleukin-1beta; Leukotriene B4; Leukotriene C4; Organ Culture Techniques; Prostaglandins; Receptors, Glucocorticoid; Receptors, Progesterone; RNA, Messenger; Young Adult

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), 17beta-estradiol (17beta-E2), progesterone and prostaglandin F 2alpha metabolite (15-keto-13,14-dihydro-PGF 2alpha) 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 17beta-E2 concentration was higher in the late follicular phase (p = 0.0449). No differences were seen for LH, progesterone and PGF 2alpha metabolite. The differences of oxytocin, vasopressin, FSH and 17beta-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.

Topics: Adult; Algorithms; Case-Control Studies; Dinoprost; Dysmenorrhea; Female; Gonadal Steroid Hormones; Gonadotropins; Health; Humans; Menstrual Cycle; Ovary; Oxytocin; Vasopressins; Young Adult

To observe the influence of silencing Connexin43 (Cx43) expression of partial acupoints on acupuncture effect, so as to probe into the mechanism of acupuncture treatment for primary dysmenorrhea.. The primary dysmenorrheal rat model made by oxytocin and RNA interference (RNAi) technology was used to silence the expression of Cx43 in acupoints. Fifty SD female rats were divided into five groups, a normal group (N), a model group (M), an acupuncture group (A), an acupuncture plus interference group (A+I), an acupuncture plus interference control group (A+IC). RT-PCR method was used to observe the oxytocin receptor (OTR) and vasopressin receptor (VPR) mRNA expressions in the uterus in each group. Plasma prostaglandin E2 (PGE2) and PGF2alpha levels were detected by radioimmunoassay and ELISA, respectively.. (1) The times of writhing body (9.43 +/- 3.87 and 10.28 +/- 4.23) were significantly lower and the latency period of writhing body (12.43 +/- 3.46, 11.00 +/- 3.65) were longer in the group A and the group A+IC as compared with (15.43 +/- 5.13, 17.00 +/- 3.87) and (7.57 +/- 1.99, 8.43 +/- 2.57) in the group M and group A+I (P < 0.05), respectively. (2) The levels of Cx43 mR NA level and protein expression of acupoint in the group A+I were significantly lower than those of the group N (P < 0.05). (3) OTR and VPR mRNA in the uterus in the group A and the group A+IC were significantly lower than those in the group M and the group A+I (P < 0.05), with no significant difference between the group M and the group A+I (P > 0.05). (4) As compared with the group M, PGE2 level increased and PGF2alpha level decreased in the group A and the group A+IC (P < 0.05).. Silencing Cx43 expression of partial acupoint can inhibit effectively the effect of acupuncture through decreasing OTR and VPR in endometrium of the dysmenorrheal rat and adjusting the prostaglandins (PGs) synthesis system, which possibly is one of the mechanisms of acupuncture for treatment of primary dysmenorrhea.

Topics: Acupuncture Points; Acupuncture Therapy; Animals; Connexin 43; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Gene Expression; Humans; Random Allocation; Rats; Rats, Sprague-Dawley; Receptors, Oxytocin; Receptors, Vasopressin; Uterus

In the present study, the effects of ligustilide (LIG) on uterine contraction in vitro were investigated. In isolated rat uterine, LIG (2-8 microg/ml) inhibited the spontaneous periodic contraction in a concentration-dependent manner (EC(50)=4.4 microg/ml, 95% confidence interval 2.7-6.1 microg/ml), and attenuated prostaglandin F2alpha (PGF(2)alpha)- or acetylcholine chloride (Ach)-induced uterine contractions. At 8 microg/ml, LIG nearly completely blocked the PGF(2)alpha-induced contractions (95.3%). In the case of Ach-induced contraction, about 73.9% was inhibited by LIG at this dosage. It was also observed that LIG affected significantly oxytocin-induced increase in the contraction of uterine horns that were incubated not only in the Locke solution but also in a Ca(2+)-free solution. In addition, LIG caused concentration-dependent inhibition of uterine contraction induced by K(+) (56.3 Mm) depolarization, reaching the significant level at 2 microg/ml (EC(50)=3.3 microg/ml, 95% confidence interval 2.5-4.1 microg/ml). The findings clearly show that LIG has multiple effects on the uterine smooth muscles, suggesting that LIG possesses a non-specific antispasmodic function. The data also imply strongly that LIG is one of active ingredients of Danggui and has the potential to be developed into an effective drug for the prevention and treatment of primary dysmenorrhoea.

Topics: 4-Butyrolactone; Acetylcholine; Angelica; Animals; Calcium; Dinoprost; Dose-Response Relationship, Drug; Dysmenorrhea; Female; Oxytocics; Oxytocin; Phytotherapy; Potassium; Rats; Uterine Contraction; Uterus

To investigate the activity of different forms of endometriosis implants by clinical and biochemical evaluation.. Prospective, blinded study.. Tertiary-care university hospital.. Forty-seven infertile patients with minimal or mild endometriosis diagnosed at laparoscopy were included in the clinical investigation.. Patients were submitted to a preoperative evaluation of endometriosis-associated dysmenorrhea by means of a 10-point linear analog scale and to laparoscopic staging of endometriosis following a current classification system. In the biochemical investigation, tissue samples from different endometriosis lesions and control tissues were assessed for prostaglandin (PG) F(2 alpha) production.. Evaluation of the correlation between endometriosis-associated dysmenorrhea and the extent of the disease. Evaluation of the production of PGF(2 alpha) by the different tissues sampled.. No positive correlation was present between any of the implant subgroups and the associated dysmenorrhea. White peritoneal implants were associated with milder pain symptoms than black or red lesions. The biologic activity of red and black superficial implants, expressed as the production of PGF(2 alpha), was similar.. No positive correlation was demonstrated between endometriosis-associated dysmenorrhea and the current classification of endometriosis, which includes characterization of the different morphologic aspects of superficial endometriosis implants.

Topics: Adult; Dinoprost; Dysmenorrhea; Endometriosis; Female; Humans; Laparoscopy; Pelvic Pain; Preoperative Care; Prospective Studies

In a pilot study we investigated the association between concentrations of various eicosanoids in menstrual blood with pain and oral contraceptive use. Menstrual fluid was collected on tampons by 12 women who did not use an oral contraceptive but suffered from slight primary dysmenorrhea and by three pain-free women who used an oral contraceptive. Eicosanoids (cyclooxygenase products: 6-ketoprostaglandin F1 alpha, thromboxane B2, prostaglandin E2, prostaglandin F2 alpha, 13,14-dihydro-15-ketoprostaglandin F2 alpha, 12-hydroxy-heptadecatrienoic acid; lipoxygenase products: 5-, 12-, 15-hydroxy-eicosatetraenoic acid (HETE), leukotriene B4, leukotriene C4, leukotriene D4, leukotriene E4) and female sex steroids (17 beta-estradiol and progesterone) were analyzed by the combined use of high-performance liquid chromatography and radioimmunoassay. 12-HETE was the main arachidonic acid metabolite. An increased metabolism of arachidonic acid was associated with pain, especially when synthesis of 12-HETE was elevated. Oral contraceptive use decreased the synthesis of prostaglandins as well as leukotrienes. The concordant changes of cyclooxygenase and lipoxygenase products in dysmenorrhea or in oral contraceptive use may be explained by an increased or decreased phospholipid metabolism, respectively.

Topics: 12-Hydroxy-5,8,10,14-eicosatetraenoic Acid; Arachidonic Acid; Body Fluids; Contraceptives, Oral, Hormonal; Dinoprost; Dysmenorrhea; Eicosanoids; Estradiol; Female; Humans; Hydroxyeicosatetraenoic Acids; Menstruation; Pilot Projects; Progesterone; Thromboxane B2

The role of prostaglandins (PGs) in dysmenorrhea of endometriosis is poorly understood. The relationship between dysmenorrheic severity and prostaglandin production was investigated in endometriosis. Slices of normal myometrium, adenomyosis, normal ovary and endometrial cyst were incubated. 6-Keto-PGF1 alpha (a metabolite of PGI2), TXB2 (a metabolite of TXA2), PGF2 alpha, and PGE2 concentrations of the incubation medium were measured by RIA. The results showed that 6-keto-PGF1 alpha production in adenomyosis and endometrial cyst were significantly higher than those in normal myometrium and ovary. A direct relationship between the degree of dysmenorrheic severity and PGs production in tissue in endometriosis was observed.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Endometriosis; Female; Humans; Middle Aged; Ovary; Prostaglandins; Thromboxane B2; Uterus

Prostanoids, leukotrienes and platelet-activating factor were measured by radioimmunoassay in menstrual blood of seven women with primary dysmenorrhea and five healthy controls. The eicosanoids and PAF concentrations in dysmenorrheic patients were significantly higher than those found in healthy women (P less than 0.005 for PGF2 alpha, 11-dehydro-TXB2, 2,3-dinor-TXB2 and LTC4/D4; P less than 0.001 for PAE; P less than 0.05 for PGE2 and 2,3-dinor-6-keto-PGF1 alpha). Whereas no relationship could be found between the concentrations of PGF2 alpha, PGE2, 11-dehydro- and 2,3-dinor-TXB2 and severity of primary dysmenorrhea, a close correlation between LTC4/D4 and PAF and severity of the disease was observed, particularly in patients who responded poorly to therapy with prostaglandin synthetase inhibitors. We conclude that the hyperstimulation of myometrial activity is not caused by selective stimulation of one metabolic pathway of arachidonic acid, but rather by an overall stimulation of phospholipid metabolism. The assessment of prostanoids, leukotrienes and PAF in menstrual blood many be useful as a direct index of primary dysmenorrhea, and the development of their antagonists may have therapeutic implications in improved treatment of the disease.

Topics: Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Humans; Menstrual Cycle; Platelet Activating Factor; SRS-A

Ten adolescents with primary dysmenorrhea (PD) were treated with the oral contraceptive (OC) Lyndiol 2.5 mg (R) for one cycle. The levels of PGF2 alpha, PGE2 and the metabolites of PGI2 and TXA2: 6-keto-PGF1 alpha and TXB2 were tested by a radioimmunoassay method during the 1st and 23rd day of the pre-treatment cycle (PrTC), the 23rd day of treatment (TC) and the 1st day of the post-treatment cycle (PoTC). The ratios PGF2 alpha/PGE2 and TXB2/6-keto-PGF1 alpha were also tested and compared during the above-mentioned days. Analytical comparison was made, for each Prostaglandin (PG) separately, between the 1st day of the PrTC and PoTC as well as the 23rd day of the PrTC and TC, respectively. All PG levels during TC and PoTC were found significantly lower, compared to those of the PrTC respectively. With regard to the ratios mentioned above, no statistically significant differences were found on the same days and cycles as previously stated. The reduction of the PG levels in PD patients after treatment with oral contraceptives, together with an improvement of the clinical findings of the disease, support the theory that oral contraceptives can be used for the treatment of PD cases, especially for those adolescents who also desire a contraceptive method.

Topics: 6-Ketoprostaglandin F1 alpha; Adolescent; Adult; Contraceptives, Oral, Combined; Dinoprost; Dinoprostone; Drug Combinations; Dysmenorrhea; Epoprostenol; Ethinyl Estradiol; Female; Humans; Lynestrenol; Mestranol; Pregnancy; Prostaglandins; Thromboxane B2

The results showed that several blood rheological indexes of dysmenorrhea patients were abnormal, the contents of plasma prostaglandin F2 alpha (PGF2 alpha) and menstrual blood PGF2 alpha of the patients were significantly higher than those of the normal women. The abnormal indexes were recovered to normal range after the patients had been treated with Danggui Shaoyao Powder for 3 months. Danggui Shaoyao Powder had better actions of improving the abnormal indexes than Tianqi Dysmenorrhea Capsule did.

Topics: Adult; Blood Viscosity; Dinoprost; Drugs, Chinese Herbal; Dysmenorrhea; Female; Humans; Powders; Rheology

Mechanisms for the therapeutic effect of oral contraceptives in dysmenorrhea were studied by recording intrauterine pressure on the first day of menstrual bleeding in women with moderate to severe symptoms and after three weeks of oral contraceptive therapy (150 micrograms levonorgestrel + 30 micrograms ethinyl estradiol, daily). Spontaneous uterine activity and reactivity to intravenous injections of vasopressin (6 pmol/kg body weight; n = 8) or prostaglandin F2 alpha (12 nmol/kg body weight; n = 9) at the two sessions were compared. During the first recording when all women had dysmenorrhea, the uterine activity and reactivity to both agonists were pronounced. After therapy, when the women felt essentially no pain, a statistically significant decrease in spontaneous uterine activity in terms of total pressure area, frequency and amplitude of contractions was observed. The agonist injections induced less pain at the second recording, although the magnitude of responses, superimposed on the much smaller uterine activity at this time, were not significantly different from those at the first recording during dysmenorrhea. The mechanism of pain relief by oral contraception in dysmenorrhea could be a lesser impact of the decreased contractile activity on uterine blood flow, abolishing the local ischemia. A reduced uterine reactivity to agonists might also to some extent contribute to the therapeutic effect.

Topics: Adult; Contraceptives, Oral; Dinoprost; Dysmenorrhea; Ethinyl Estradiol; Female; Humans; Levonorgestrel; Lypressin; Menstrual Cycle; Norgestrel; Pressure; Uterine Contraction; Uterus

The mechanisms underlying the therapeutic effect of an oral contraceptive (150 micrograms levonorgestrel and 30 micrograms ethinyl estradiol daily for 21 days) in primary dysmenorrhea were studied by recordings of uterine activity and reactivity to lysine (L) vasopressin (VP) and prostaglandin (PG) F2 alpha on the first day of menstruation in 14 women before and after one period of oral contraceptive treatment. During the first session, when all women had moderate to severe dysmenorrhea, intra-uterine pressure recording showed an intensive uterine activity, and bolus injections of LVP (6 pmol/kg body weight; 6 subjects) or PGF2 alpha (6 or 12 nmol/kg body weight; 4 subjects in each group) increased contractile activity and discomfort. After oral contraceptive treatment, spontaneous uterine activity, measured as total pressure area, decreased significantly (p = 0.02 and p = 0.03 in the VP and PG groups, respectively). The mean uterine responses to LVP and PGF2 alpha were on average smaller after oral contraceptive treatment and the women experienced minimal discomfort after this injection. It is suggested that inhibition of uterine activity could be an important mechanism for the therapeutic effect of gestagen-dominated oral contraceptives in primary dysmenorrhea and that reduced uterine reactivity to agonists might contribute to this effect.

Topics: Adolescent; Adult; Contraceptives, Oral, Combined; Dinoprost; Dysmenorrhea; Female; Humans; Lypressin; Pressure; Uterine Contraction; Uterus

Oral contraceptives reduce menstrual pain but the interaction with vasopressin and prostaglandin F2 alpha, two uterine stimulants related to the condition, is unknown. Ten women with a history of moderate to severe dysmenorrhoea were studied. Repeated blood samples were taken during a first menstrual cycle without treatment, during the first 21 days of a second cycle when they received an oral contraceptive (150 micrograms levonorgestrel and 30 micrograms ethynyloestradiol) and on the first or second day of the bleeding following hormonal withdrawal. Measurements were made of plasma concentrations of arginine vasopressin, 15-keto-13,14-dihydroprostaglandin F2 alpha, oestradiol-17 beta, progesterone, ethynyloestradiol, levonorgestrel, FSH, LH and prolactin, and serum osmolality was measured. Seven of the women rated their discomfort as moderate to severe on the first two menstruations, but as none or light at the withdrawal bleeding; with the rating scale for degree of pain that was used, this decrease in pain was significant (P less than 0.001). The plasma concentration of vasopressin in these seven women showed significant variation, with the highest concentrations being obtained at the beginning of the two painful menstruations (3.76 +/- 0.76 and 1.75 +/- 0.30 (S.E.M.) pmol/l) and at ovulation in the control cycle (1.91 +/- 0.58 pmol/l). During treatment the concentrations were consistently low, except on the first day of withdrawal bleeding (2.33 +/- 0.35 pmol/l). The concentrations of the prostaglandin F2 alpha metabolite showed less variation, but again the values at withdrawal bleeding (271 +/- 39 pmol/l) were not different from those obtained over the painful menstruations (255 +/- 24 and 217 +/- 25 pmol/l).(ABSTRACT TRUNCATED AT 250 WORDS). To learn more about the beneficial effect of combined oral contraceptives (OCs) on symptoms in primary dysmenorrhea, plasma levels of vasopressin and a prostaglandin F2-alpha metabolite in dysmenorrheic women were investigated before and during treatment with a gestagen-dominated OC. The 10 subjects were administered an OC containing 150 mcg of levonorgestrel and 30 mcg of ethinyl estradiol for 21 days. The 7 women with dysmenorrheic symptoms at the time of blood sampling during the 1st menstruation graded their pain as averaging 2.1 (moderate to severe) + or - 0.3; during the 2nd menstruation, the average value was 2.9 (severe) + or - 0.1, indicating a significant increase in pain at the start of the withdrawal bleeding. Vasopressin concentrations in samples obtained on days 1-3 of the control cycle were significantly higher than those on days 6-8, 20-22, and 24-26 of the control cycle and days 1-2 of the next menstruation. Thus, the highest concentrations were obtained at the beginning of the 2 painful menstruations and at ovulation in the control cycle. During treatment, vasopressin concentrations were consistently low, except on the 1st day of withdrawal bleeding. The concentrations of the prostaglandin F2-alpha metabolite showed less variation, again, values at withdrawal bleeding were not different from those obtained during painful menstruation. Plasma concentrations of ovarian and adenohypophysial hormones, as well as osmolality, were normal throughout. Thus, the present study provided no evidence that there is a reduced release of vasopressin and/or prostaglandin F2-alpha capable of accounting for the beneficial effect of OCs on dysmenorrhea. It is possible, however, that a difference in ovarian hormone concentrations is more pronounced in uterine tissue than in plasma.

Topics: Adolescent; Adult; Arginine Vasopressin; Contraceptives, Oral, Combined; Dinoprost; Dysmenorrhea; Ethinyl Estradiol; Female; Humans; Levonorgestrel; Norgestrel; Prostaglandins F

Topics: Adult; Dinoprost; Dysmenorrhea; Endometriosis; Female; Humans; Infertility, Female; Prostaglandins F

Topics: Anti-Inflammatory Agents, Non-Steroidal; Dinoprost; Dinoprostone; Dysmenorrhea; Endometrium; Female; Humans; Prostaglandin Antagonists; Prostaglandins; Prostaglandins E; Prostaglandins F

Topics: Dinoprost; Dysmenorrhea; Female; Humans; Medicine, Chinese Traditional; Medicine, East Asian Traditional; Plant Extracts; Plants, Medicinal; Powders; Prostaglandins F

Although it has been demonstrated that primary dysmenorrhea is associated with elevated levels of PGF2 alpha in the menstrual fluid, little is actually known of the menstrual-PG profiles of either dysmenorrheic or normal women. In this study, menstrual fluid from normal and dysmenorrheic women was collected from tampons and extracted for PG-like substances. The PGF2 alpha, PGE2 and TXA2 content was analyzed by RIA. This study demonstrates that dysmenorrheics have significantly higher levels/concentrations of menstrual-PGF2 alpha and PGE2 than do normal women, and that there is no difference in the menstrual-PGF2 alpha : PGE2 ratio between the two groups. Also, there is no significant difference in the amount/concentration of menstrual-thromboxane between dysmenorrheic and normal women. Of the parameters considered, the levels/-concentrations of menstrual-PGF2 alpha, PGE2 and TXA2, dysmenorrheic pain correlates best with the rate of menstrual-PGF2 alpha release.

Topics: Adolescent; Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Humans; Menstruation; Prostaglandins E; Prostaglandins F; Radioimmunoassay; Thromboxane A2; Thromboxane B2; Thromboxanes; Time Factors

The diurnal uterine activity in four normal women in the secretory phase of their menstrual cycles and one woman suffering from dysmenorrhea were studied in relation to concomitant hormone levels in blood (progesterone, hGH, prolactin, cortisol, vasopressin, and 15-keto-13,14-dihydro-PGF2 alpha). In the four normal women uterine activity decreased after midnight, unrelated to circulating levels of 15-keto-13,14-dihydro-PGF2 alpha. But during a dysmenorrheic episode the uterine hypercontractility pattern correlated well with levels of the PGF2 alpha-metabolite, indicating a role of endogenous-produced PGF2 alpha in this condition. The results demonstrate a diurnal rhythm, possibly related to the wake-sleep cycle. No simple associations were seen between vasopressin, cortisol, prolactin, hGH, the PGF2 alpha-metabolite, and uterine activity.

Topics: Circadian Rhythm; Dinoprost; Dysmenorrhea; Female; Humans; Hydrocortisone; Menstruation; Prolactin; Prostaglandins F; Sleep; Uterine Contraction; Vasopressins; Wakefulness

Both vasopressin and PGF2 alpha are effective uterine stimulants in the non-pregnant human uterus, especially around the onset of menstruation. In order to clarify the relationship of these hormones to menstrual pain, plasma concentrations of vasopressin and two prostaglandin metabolites (15-keto-13,14-dihydro-PGF2 alpha and 11-ketotetranor PGF metabolites) were measured in serial blood samples taken premenstrually and during menstruation. Five women with premenstrual pain gave 7-9 blood samples at intervals of 30 minutes on the day preceding the onset of menstruation. From 5 women with severe primary dysmenorrhea a corresponding series of blood samples were taken during the first day of menstruation. Two groups of 5 women with no symptoms served as controls, either premenstrually or during menstruation. In the women with premenstrual pain the vasopressin concentrations were significantly higher than in the corresponding control group. Even higher and markedly fluctuating vasopressin levels were found in the women with dysmenorrhea who, in general, had more intense pain than the women with premenstrual symptoms. In the group with dysmenorrhea there was also a significant rise in plasma concentration of the PG metabolites. No such increase was seen in the group with premenstrual pain. It is concluded that the pathophysiology of premenstrual pain could imply increased vasopressin secretion. The more severe pain in primary dysmenorrhea seems to be the result of a combined effect of vasopressin and PGF2 alpha.

Topics: Adolescent; Adult; Dinoprost; Dysmenorrhea; Estradiol; Female; Humans; Osmolar Concentration; Pain; Premenstrual Syndrome; Progesterone; Prostaglandins F; Vasopressins

Menstrual fluid was collected in vaginal cups inserted for 2 h during the first 2 days of menstruation and menstrual serum concentrations of prostaglandins PGF2 alpha and PGE2 were measured by radioimmunoassay. In 16 women from whom menstrual fluid was collected on both days, PGF2 alpha and PGE2 concentrations were significantly higher on day 1 than on day 2. The highest concentrations of PGF2 alpha and PGE2 were found in dysmenorrhoeic women on day 1. In non-dysmenorrhoeic women, the amount of PGF2 alpha and PGE2 collected in 2 h correlated directly with total menstrual blood loss. There was no statistically significant difference in the amount of prostaglandins collected in 2 h in pain-free menorrhagic women and dysmenorrhoeic women with normal loss. There was also no significant 9-ketoreductase or 9-hydroxydehydrogenase activity present in menstrual fluid which could suggest PGE2 to PGF2 alpha interconversion.

Topics: Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Humans; Menorrhagia; Menstruation; Middle Aged; Prostaglandins E; Prostaglandins F

Menstrual blood was collected from five eumenorrheic and seven dysmenorrheic women aged between 20 and 35 years for a period of three cycles each. The levels of prostaglandin F2 alpha (PGF2 alpha), prostaglandin E2 (PGE2), 6-keto-prostaglandin F1 alpha (6-k-PGF1 alpha)-the stable metabolite of prostacyclin (PGI2)-, oestradiol, oestrone, and progesterone were determined radioimmunologically. Both eumenorrheic and dysmenorrheic women showed identical blood losses. The levels of oestradiol excreted by the dysmenorrheic women were markedly elevated as compared to the non-dysmenorrheic subjects (2 p less than 0.05). Oestrone excretion was in the same order of magnitude in all subjects examined. The concentration of progesterone per menstruation was significantly higher in the eumenorrheic women (2 p less than 0.02) than in the dysmenorrheic patients. Menstrual excretion of PGF2 alpha was 2.5 times higher in the dysmenorrheic women compared to the normal subjects (2 p less than 0.05). The levels of PGE2 was identical in both groups. Excretion of 6-k-PGF1 alpha was significantly lower in the dysmenorrheic women than in the eumenorrheic subjects (2 p less than 0.02). The oestradiol/progesterone ratio showed a distinct predominance of oestradiol in the dysmenorrheic patients. PGF2 alpha dominance in the dysmenorrheic patients is expressed by the PGF2 alpha/6-k-PGF1 alpha and the PGF2 alpha/PGE2 ratios. A shift in the oestradiol/progesterone ratio in favour of oestradiol seems to be the underlying pathogenic principle of dysmenorrhea. The oestradiol dominance is associated with a shift in the PGF2 alpha/PGI2 and the PGF2 alpha/PGE2 proportions. Thus, the PGF2 alpha predominance and a simultaneous reduction of PGI2 in uterine tissue seem to be responsible for dysmenorrheic bleeding.

Topics: Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Estradiol; Estrogens; Estrone; Female; Humans; Menstruation; Progesterone; Prostaglandins; Prostaglandins E; Prostaglandins F; Radioimmunoassay

The topography of prostaglandin (PG) E and F2 alpha receptors in uteri of premenopausal women was investigated by dividing uteri into six equal longitudinal strips and further dividing each strip into approximately 1-cm segments. Tissue for determination of smooth muscle content using the Trichrome stain was taken from each section, and the remainder was homogenized for binding studies with 3H-labeled PGs. The [3H] PGE1 binding (mean, 41.5 fmol/mg protein; range, 23.1-58.3) was about 8-fold greater in the fundus than [3H]PGF2 alpha binding (mean, 4.8 fmol/mg protein; range, 1.3-13.0), and this trend was found in most uterine sections. The binding of both 3H-labeled PGs decreased from fundus to cervix, and this decrease was similar to the decrease in smooth muscle content. Scatchard analysis revealed apparent dissociation constants (Kds) of 1.4 and 76 nM and apparent specific binding capacities (Ns) of 25 and 488 fmol/mg protein for [3H]PGE2, and Kd values of 11.5 and 81 nM and Ns values of 19.4 and 58 fmol/mg protein for [3H]PGF2 alpha in the uterine fundus. The Kd values for [3H]PGE2 were similar in other sections of the uterus, but the Ns values were smaller in the lower uterine body and cervical end. While the phase of the menstrual cycle did not influence [3H]PG binding, the diagnosis of abnormal uterine bleeding compared to dysmenorrhea was associated with an increase in [3H]PGE1 binding (P less than 0.05).

Topics: Adult; Dinoprost; Dysmenorrhea; Female; Genital Diseases, Female; Humans; Menstruation; Middle Aged; Muscle, Smooth; Prostaglandins E; Prostaglandins F; Receptors, Cell Surface; Receptors, Prostaglandin; Receptors, Prostaglandin E; Tissue Distribution; Urinary Incontinence, Stress; Uterine Hemorrhage; Uterus

Small longitudinally or helically cut strips from the ascending branch of the uterine artery were mounted in organ chambers for isometric recording of contractile activity. PGI2(3-300 ng/ml) caused a concentration-dependent relaxation of spontaneously active preparations, whereas no inhibitory effect could be observed on non-active strips. Furthermore, the compound counteracted the stimulatory effects of PGE2, PGF2 alpha, and NA, but not that of transmural nerve stimulation. The effect of PGI2 could be of interest in that the compound may balance the action of vasoconstricting agents. A disturbance of this balance may be a hitherto unrecognized contributing pathophysiological mechanism in the development of dysmenorrhea.

Topics: Arteries; Dinoprost; Dinoprostone; Dysmenorrhea; Epoprostenol; Female; Humans; In Vitro Techniques; Muscle Contraction; Muscle, Smooth, Vascular; Norepinephrine; Prostaglandins; Prostaglandins E; Prostaglandins F; Uterus

The concentrations of prostaglandin F2 alpha (PGF2 alpha) and E2 (PGE2) in menstrual fluid collected daily from 13 women with primary dysmenorrhoea and 11 matched controls, were compared with the pattern of uterine contractility during the hour following the menstrual fluid collection. The intra-uterine pressure (IUP) was measured using a micro-transducer catheter and the tracings analysed. On Day 2 the concentration of PGF2 alpha correlated with the peak area, but not with amplitude, duration or rate of contraction. These findings add additional support to the hypothesis that increased production of PGF2 alpha could contribute to the increased uterine contractility in primary dysmenorrhoea.

Topics: Dinoprost; Dysmenorrhea; Female; Humans; Menstruation; Myometrium; Prostaglandins F; Uterine Contraction; Uterus

Menstrual fluid was collected in a contraceptive diaphragm from 16 women with primary dysmenorrhoea and 12 matched control subjects without dysmenorrhoea. Prostaglandins F2 alpha (PGF2 alpha), E2 (PGE2) and 6-oxo-prostaglandin F1 alpha (6-oxo-PGF1 alpha) were extracted and measured using gas-chromatography: mass spectrometry (GC:MS). The concentrations of both PGF2 alpha and PGE2 were higher on days 1 and 2 in the dysmenorrhoea group than in the control group and the concentration of PGF2 alpha was higher on day 1 than on day 2 in the dysmenorrhoea group. The concentrations of 6-oxo-PGF1 alpha (the stable metabolite of PGI2) were low in both groups. These results confirm suggestions that PGF2 alpha is important in the aetiology of dysmenorrhoea and also indicate that PGE2 may be involved.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Body Fluids; Dinoprost; Dinoprostone; Dysmenorrhea; Female; Gas Chromatography-Mass Spectrometry; Humans; Menstruation; Prostaglandins E; Prostaglandins F

An in situ model for studying factors related to dysmenorrhea and for evaluating drugs for their inhibitory effects on uterine contractility induced by arachidonic acid and prostaglandins has been developed. Intravenous administration of arachidonic acid and PGF2 alpha to guinea pigs during the late stage of the estrous cycle, induced dose related uterine contractions and an elevation in uterine basal pressure similar to that seen in patients with dysmenorrhea. Pretreatment with prostaglandin synthetase inhibitors inhibited the response to arachidonic acid. The order of relative potency was suprofen (1) greater than indomethacin (0.65) greater than naproxen (0.52) greater than ibuprofen (0.43) greater than aspirin (0.31). The effectiveness or maximal response for suprofen was significantly greater than that of the other compounds tested. Simultaneous administration of suprofen with PGF2 alpha also blocked induction of uterine contractions, suggesting the possibility that suprofen also antagonizes PGF2 alpha receptor binding. Bradykinin also induced uterine contractions, an effect blocked by pretreatment with suprofen. Finally, histochemical studies demonstrated stimulation of uterine catecholamine levels (norepinephrine) by arachidonic acid, PGF2 alpha and bradykinin. These effects were blocked by suprofen. These data suggest that suprofen, an analgesic prostaglandin synthetase inhibitor, may be of use in the clinical treatment of uterine contractions associated with primary dysmenorrhea.

Topics: Animals; Arachidonic Acid; Arachidonic Acids; Bradykinin; Catecholamines; Cyclooxygenase Inhibitors; Dinoprost; Disease Models, Animal; Dose-Response Relationship, Drug; Dysmenorrhea; Female; Guinea Pigs; Histocytochemistry; Microscopy, Fluorescence; Phenylpropionates; Prostaglandins F; Suprofen; Uterine Contraction; Uterus

PGE2, PGF2 alpha, and 13,14-dihydro-15-keto-PGF2 alpha were determined in two-day intervals by means of radio-immuno-assay from plasma of the arm veins of eight women with primary dysmenorrhoea. No evidence could be produced to any rise in plasma concentration of primary prostaglandins and of the main metabolite of PGF2 alpha in the course of one full menstrual cycle. These findings are likely to show that in cases of dysmenorrhoea determination of prostaglandins in peripheral venous blood is unsuitable for verification of high endogenous formation from the endometrium.

Topics: Biotransformation; Dinoprost; Dinoprostone; Dysmenorrhea; Estradiol; Female; Humans; Prostaglandins; Prostaglandins E; Prostaglandins F; Radioimmunoassay

In a double-blind, crossover study of 32 women with primary dysmenorrhea, the analgesic efficacy of naproxen sodium was compared to that of aspirin and placebo. The treatment started 1 to 5 days before the onset of menses and continued for 3 to 5 days. At the same time, a radioimmunoassay established concentrations of 13,14-dihydro-15-keto-prostaglandin F2-alpha, a prostaglandin F2-alpha metabolite (PGF-M) in blood samples obtained from before the treatment and on the first day of menses. In affording pain relief, naproxen sodium was superior to aspirin (p = 0.02) and placebo (p = 0.002); however, aspirin was not superior to placebo (p = 0.05). During naproxen sodium treatment, the patients' daily activities were less impaired than during both the aspirin and the placebo treatment courses. During naproxen sodium treatment, the mean blood PGF-M levels decreased by 73.5%, from a mean of 50.5 to 13.4 pg/ml; during aspirin treatment they decreased by 31.2%, from a mean of 44.2 to 30.4 pg/ml; during placebo treatment, an increase of 13.6% was observed, from a mean of 46.3 to 52.6 pg/ml. The PGF-M decrease during the naproxen sodium treatment was significantly more prominent than that during both aspirin and placebo treatments (p = 0.0001). Changes caused by aspirin treatment were significantly different from those occurring during the placebo treatment (p = 0.001). The study confirms that at the doses utilized in this study the analgesic properties of naproxen sodium are superior to those of the more conventional prostaglandin synthetase inhibitor, aspirin, and that pain relief is related to the inhibition of prostaglandin synthesis.

Topics: Activities of Daily Living; Adolescent; Adult; Aspirin; Dinoprost; Double-Blind Method; Drug Evaluation; Dysmenorrhea; Female; Humans; Naproxen; Placebos; Prostaglandins F