Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The discussion reports on the history, etiology, and the relationship of prostaglandins to primary dysmenorrhea, reviews old and new drugs used in the treatment; and considers future research. The history of dysmenorrhea dates back to the Greeks who defined the word as "painful menstrual flow." In 1865 the 1st surgical approach was used, consisting of a bilateral oophorectomy followed by other procedures. The relationship of dysmenorrhea and ovulation was discovered in 1938 and was treated by ovulatory suppression with estrogen. The psychogenic theory was advanced in the 1940s and many feel it still remains part of the etiology of dysmenorrhea. Until the discovery of prostaglandins and the subsequent relationship of them to dysmenorrhea, the known therapies were oral contraceptives (OCs), childbirth, sedation, narcotic analgesics, other hormones to suppress ovulation, and bed rest. The relationship of prostaglandins to primary dysmenorrhea is most likely the best explanation medical science can offer. Prostaglandins are thought by many as the etiologic agent of disease. The newest link of research deals with the implication of arginine vasopressin (AVP) as another possible integrated factor in the etiology of primary dysmenorrhea. AVP has been shown to be elevated in women with dysmenorrhea, but how AVP integrates into the sequence of events surrounding painful uterine contractions is unknown. The 2 main modes of therapy are OCs and nonsteroidal anti-inflammatory drugs (NSAIDS). Each has separate indications for use. It is recommended that when relief is not found in 6-12 months that causes of secondary dysmenorrhea be ruled out. OCs have been shown to be quite effective in all groups of women with dysmenorrhea, significantly reducing symptoms in 80-98% of the population. The use of OC in dysmenorrhea is recommended in women who are young, sexually active and who seek contraception, and relief of symptoms related to dysmenorrhea where secondary dysmenorrhea and premenstrual tension syndrome has been ruled out. NSAIDs have come to surface as the mainstay of therapy for dysmenorrhea. The major effect is that they inhibit cyclo-oxygenase. The NSAIDs are recommended for use in any woman with primary dysmenorrhea who may not want therapy with OCs and who does not have a history of peptic ulcer, dyspepsia, hepatic or renal disease, aspirin allergy, asthma, or a bleeding diathesis. At times, short term use can be permissible with some of the contraindications. Guidelines for the use of anti-PGs prophylactically are somewhat nuclear at this time.
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PMID:Primary dysmenorrhea: current concepts. 646 99