Dysmenorrhea primary

Relcovaptan (SR-49059) is a selective, orally active V1aR antagonist that prevents pain of primary dysmenorrhea and inhibits preterm labour and could be useful in the treatment of Raynaud s phenomenon. The selective ViBR antagonist SSR149415 showed beneficial effects in the treatment of depression and anxiety in several animal models. 

Mild to moderate pain, rheumatoid arthritis and osteoarthritis Sgns and symptoms of osteoarthritis, management of acute pain, primary dysmenorrhea... 

Pain, primary dysmenorrhea 500 mg initially then 250 mg q6-8h arthritic disorders 250-500 mg PO BID... 

Dysmenorrhea is commonly defined as crampy pelvic pain occurring with or just prior to menses. Primary dysmenorrhea implies pain in the setting of normal pelvic anatomy and physiology, whereas secondary dysmenorrhea is associated with underlying pelvic pathology.17... 

The most significant mechanism for primary dysmenorrhea is the release of prostaglandins in the menstrual fluid and possibly vasopressin-mediated vasoconstriction.5,17 Causes of secondary dysmenorrhea may include cervical stenosis, endometriosis, pelvic infections, pelvic congestion syndrome, uterine or cervical polyps, and uterine fibroids.20... 

Stenchever MA, Droegemueller W, Herbst AL, Mishell DR. Primary and secondary dysmenorrhea and premenstrual syndrome Etiology, diagnosis, and management. In Stenchever MA, ed. Comprehensive Gynecolgy. 4th ed. St. Louis Mosby 2001 1065-1078. 

In addition, about 15% of cases of pelvic pain are due to endometriosis, and most primary care physicians consider pelvic pain to be a common clinical problem that accounts for as much as 25% of routine gynecologic office visits (Hurd 1998). Endometriosis is frequently associated with several types of pelvic pain such as dysmenorrhea, chronic pelvic pain, deep dyspareunia, and, occasionally, painful defecation (Hurd 1998). Specifically, endometriosis was... 

Primary dysmenorrhea Diclofenac potassium, ibuprofen, ketoprofen, mefenamic acid, naproxen, naproxen sodium. 

Anaigesia and primary dysmenorrhea (diciofenac potassium oniy) -Recommended starting dose is 50 mg 3 times/day. In some patients, an initial dose of 100 mg followed by 50 mg doses will provide better relief. After the first day, when the maximum recommended dose may be 200 mg, the total daily dose generally should not exceed 150 mg. 

Mild to moderate pain, primary dysmenorrhea - 25 to 50 mg every 6 to 8 hours as needed. Give smaller dosages initially to smaller patients, the elderly, and those with renal or liver disease. Doses above 50 mg may be given, but doses above 75 mg do not display added therapeutic effects. Do not exceed 300 mg/day. 

Excessive menstrual blood loss and primary dysmenorrhea - 100 mg 3 times/day for up to 6 days, starting at the onset of menstrual flow. 

Primary dysmenorrhea - 500 mg, then 250 mg every 6 hours. Start with the onset of bleeding and associated symptoms. Should not be necessary for... 

Heavy menstrual blood loss evaluation Prior to prescribing meclofenamate for heavy blood flow and primary dysmenorrhea, make a thorough risk/benefit assessment. 

Aspirin and related salicylates are the primary treatment for mild to moderate pain, such as that associated with headache, joint and muscle pain, and dysmenorrhea. At higher doses aspirin is an effective analgesic in rheumatoid arthritis (see Chapter 36). The analgesic effects of salicylates are thought to be due to the inhibition of prostaglandin synthesis in the periphery and to a less well documented mechanism at cortical areas. 

Celecoxib has been approved for the treatment of osteoarthritis and rheumatoid arthritis, and rofecoxib has been approved for the treatment of osteoarthritis, acute pain and primary dysmenorrhea. Celecoxib and rofecoxib do not appear to differ in efficacy for the treatment of osteoarthritis. However, neither drug has efficacy greater than that of the non-selective NSAIDs. Since the COX-2 enzyme appears to play an important role in colon cancer the COX-2 inhibitors may find future uses in the treatment or prevention of colorectal cancer. 

Two compounds of the fenamate class of antiinflammatory drugs are marketed in the United States. Mefenamic acid (Ponstel) is indicated only for analgesia and primary dysmenorrhea when therapy will not exceed 1 week. Meclofenamate sodium (Meclomen) is prescribed for rheumatoid arthritis and osteoarthritis. 

Aspirin and other NSAIDs are effective in treating mild-to-moderate pain of various origins, including headache, toothache, and diffuse muscular aches and soreness. Aspirin appears to be especially useful in treating pain and inflammation in musculoskeletal and joint disorders.71,87,89 The safe and effective use of aspirin in both rheumatoid arthritis and osteoarthritis is well documented (see Chapter 16).53,66,84 Aspirin is also recommended for treating the pain and cramping associated with primary dysmenorrhea.70... 

Valdecoxib, a diaryl-substituted isoxazole, is a new highly selective COX-2 inhibitor. Pharmacokinetic characteristics and dosage in arthritis are set forth in Table 36-1. In primary dysmenorrhea, dosage is 20 mg twice daily, and the drug is as effective as nonselective NSAIDs for this indication. Gastrointestinal and other toxicities are similar to those of the other coxibs. Valdecoxib has no effect on platelet aggregation or bleeding time. Serious reactions have been reported in sulfonamide-sensitive individuals. 

Jahromi, B.N., Tartifizadeh, A. and Khabnadideh, S. (2003) Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrhea. International Journal of Gynecology and Obstetrics 80(2), 153-1 57. 

Morrison BW, Daniels SE, Kotey P, Cantu N, Seidenberg B. Rofecoxib, a specific cyclooxygenase-2 inhibitor, in primary dysmenorrhea a randomized controlled trial. Obstet Gynecol 1999 94(4) 504-8. 

Acne has been reported in a woman with primary dysmenorrhea (20). 

Hamann GO. Severe, primary dysmenorrhea treated with naproxen. A prospective, double-blind, crossover investigation. Prostaglandins 1980 19(5) 651-7. 

Because medical conditions, emotional/behavioral symptoms, and physiologic indices change during the premenstrual and per-imenopause phases, it is important to rule out other disorders that may contribute to mood fluctuations or pain syndromes (Table 78-2). For example, dysmenorrhea may be primary, which occurs during ovulatory cycles, or secondary, which relates to pelvic pathology (e.g., infection caused by the placement of intrauterine devices, endometriosis, pelvic inflammatory disease, ovarian cyst, endometrial cancer, adhesions, and benign uterine tumors). 

Primary dysmenorrhea is a prostaglandin-mediated hypertonicity of the uterine smooth muscle that constricts uterine blood vessels and leads to ischemia and menstrual pain. At menstruation, the shedding of the uterine lining releases arachidonate and stimulates... 

Wilson M, Farquhar C, Kennedy S, et al. Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhea. Cochrane Review 2001 2. 

Milsom 1, Minic M, Dawood MY, et al. Comparison of the efficacy and safety of nonprescription doses of naproxen and naproxen sodium with ibuprofen, acetaminophen, and placebo in the treatment of primary dysmenorrhea A pooled analysis of five studies. Clin Ther 2002 24 1384-1400. 

Hendrix SL, Alexander NJ. Primary dysmenorrhea treatment with a desogestrel-containing low-dose oral contraceptive. Contraception 2002 66 393-399. 

Efficacy of NS AIDs in patients with endometriosis has not been evaluated in controlled trials. However, NSAIDs have proven efficacy in treating primary dysmenorrhea and are likely to have benefit in endometriosis as well. ... 

Both increase in primary dysmenorrhea. Therapeutic effects of NSAIDs may be due to inhibition of their synthesis. 

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