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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary dysmenorrhea is a difficult entity to treat, and therapy is usually directed at relieving symptoms. There is some indication that this disorder is caused by an increase in prostaglandin F2alpha. Therefore, logically the treatment may include antiprostaglandin agents. We have studied 32 women with the diagnosis of primary dysmenorrhea in a randomized double-blind fashion using a placebo and indomethacin. Both agents were taken three times a day over four cycles, and therapy was begun two days before the usual onset of pelvic pain. Only two of 16 patients in the placebo group were significantly improved in the four-month treatment cycles while all 16 in the treatment group showed some improvement, 11 having cessation of pain. In the six months following the study period, all patients were given indomethacin. The original treatment group did not change significantly. However, all in the placebo group when switched to indomethacin had some relief, 12 of the 16 showing complete cessation of pain. Gastric irritation was the main side effect and was present in 18% of the treatment group and 12% in the placebo group. Indomethacin appears to effectively relieve primary dysmenorrhea and does not appear to be associated with a high incidence of side effects.
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PMID:Primary dysmenorrhea treated with indomethacin. 37 24

The possible role of prostaglandins (PGs) in the biochemistry of endometriosis prompted this placebo-controlled double-blind trial evaluating the effect of PG-inhibitors on symptoms of endometriosis (especially pelvic pain). The 4 drugs used were: 1) placebo, 2) acetylsalicylic acid (ASA), 3) indomethacin, and 4) tolfenamic acid. Each drug was administered orally from Day 20 of the menstrual cycle until end of menstruation for 2 consecutive cycles. During menstruation, tolfenamic acid (P.01) and ASA (P.05) lowered the endometriosis score from the pretreatment level. Tolfenamic acid was more effective than placebo (P.05), whereas ASA and indomethacin did not differ from placebo. Each treatment, including placebo, lowered the endometriosis score (P.05) during the menstrual period, but none of the PG inhibitors was more effective than placebo (P.05). According to patient's subjective judgements, tolfenamic acid alleviated symptoms more effectively than other drugs tested. Pain symptoms occurred less often during tolfenamic acid and ASA than during placebo or indomethacin (P.05). Gastrointestinal side effects were more common with indomethacin and ASA (P.05). Indomethacin treatment raised the incidence of psychic complaints over those with ASA or placebo (P.05). Side effects were fairly evenly distributed among the therapies.
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PMID:Prostaglandin biosynthesis inhibitors and endometriosis. 53 Dec 32

The efficacy of indomethacin suppositories (100 mg 1-3 times a day) in the treatment of primary dysmenorrhoea was investigated in a double-blind, crossover study involving 40 patients, in comparison to placebo. The patients were treated for four menstrual periods-two periods with placebo and two periods with indomethacin suppositories. A dysmenorrhoeic score based on subjective estimations of nine symptoms was used, the symptoms including pelvic pain, backache, headache, dizziness, nausea, vomiting, diarrhoea, nervousness and incapacitation. As compared to placebo, indomethacin suppositories led to a insignificant decrease in the frequency and severity of the associated symptoms, as evaluated by subjective rating (P less than 0.05). Indomethacin suppositories were well tolerated and there was no drop-out. No side effects were reported except for a mild burning sensation in the rectal region experienced by 3 patients on indomethacin suppositories.
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PMID:Efficacy of indomethacin suppository in primary dysmenorrhoea. 222 77

The physiology of primary dysmenorrhea and its treatment with nonsteroidal anti-inflammatory agents are reviewed. Primary dysmenorrhea involves incapacitating pelvic pain associated with nausea, vomiting, and diarrhea. Currently, it is thought to be caused by an overproduction of prostaglandins that are released as the endometrium degenerates. Since the nonsteroidal anti-inflammatory agents are one class of antiprostaglandin agents, they are frequently prescribed for the relief of dysmenorrhea. Naproxen and naproxen sodium have both been shown to be superior to placebo in subjective and objective assessments of dysmenorrheic patients when administered at the onset of symptoms. Indomethacin studies demonstrate its efficacy over placebo, but the frequency of side effects at the doses used (25-50 mg t.i.d.) diminish its usefulness. Few placebo-controlled studies have been published on ibuprofen, but the studies that have been performed show that ibuprofen is more beneficial than placebo for treating dysmenorrhea with a low incidence of side effects. The fenamates appear to be effective in dysmenorrhea, although they were not studied extensively with placebo and previous experience with mefenamic acid has led to warnings about side effects. Phenylbutazone and oxyphenbutazone have been found to be effective; however, their use has been less frequent since the introduction of the newer less toxic nonsteroidal agents. Comparative studies of the nonsteroidal anti-inflammatory agents have not indicated that one agent is more effective than the others. Until further well-controlled comparative research is performed, any of the agents reviewed would be an appropriate choice in the treatment of primary dysmenorrhea.
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PMID:Nonsteroidal anti-inflammatory agents in the treatment of primary dysmenorrhea. 676 92