Effect of an oral contraceptive in primary dysmenorrhea--changes in uterine activity and reactivity to agonists.

Abstract:

: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.

journal_name

Contraception

journal_title

Contraception

authors

Ekström P,Juchnicka E,Laudanski T,Akerlund M

doi

10.1016/0010-7824(89)90026-7

subject

Has Abstract

pub_date

1989-07-01 00:00:00

pages

39-47

issue

1

eissn

0010-7824

issn

1879-0518

pii

0010-7824(89)90026-7

journal_volume

40

pub_type

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