Abstract
Objective
To investigate the severity of pain and circadian changes in uterine artery blood flow in primary dysmenorrhea cases.
Materials and methods
The study included 27 cases diagnosed as primary dysmenorrhea and 25 individuals who had no dysmenorrhea complaint. Bilateral uterine artery systole/diastole rates (S/D), pulsatility indices (PI) and resistance indices (RI) of all cases were measured using transvaginal colour Doppler at 12.00–02.00 p.m. and 12.00–02.00 a.m. Severity of pain was evaluated in dysmenorrhea cases at the same hours using a verbal pain assessment scale.
Findings
Doppler measurements of dysmenorrhea cases conducted at 12.00–02.00 p.m. showed right uterine artery S/D: 3.37 ± 0.26, RI: 0.73 ± 0.07, PI: 2.38 ± 0.34 and left uterine artery S/D: 3.33 ± 0.37, RI: 0.74 ± 0.14, PI: 2.41 ± 0.15, while measurements carried out at 12.00–02.00 a.m. showed right uterine artery S/D: 3.88 ± 0.12, RI: 0.87 ± 0.14, PI: 2.94 ± 0.21 and left uterine artery S/D: 3.90 ± 0.27, RI: 0.92 ± 0.12, PI: 2.93 ± 0.21. Comparisons revealed significantly higher Doppler indices at night (P < 0.05) than in the day in dysmenorrhea cases. There was not any significant circadian difference in individuals who did not have dysmenorrhea (P > 0.05). Pain score in the verbal pain assessment of dysmenorrhea cases was found 3.6 ± 1.4 in the day and 5.8 ± 1.7 at night. The difference was found significant (P < 0.05).
Conclusion
Uterine artery blood flow is reduced at night in dysmenorrhea cases. In correlation with this, the cases feel more pain at night. Our results may be important on the planning of working hours and their quality of life.
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References
Coco AS (1999) Primary dysmenorrhea. Am Fam Physician 60:489–496
Strömberg P, Akerlund M, Forsling ML, Granström E, Kindahl H (1984) Vasopressin and prostaglandins in premenstrual pain and primary dysmenorrhea. Acta Obstet Gynecol Scand 63:533–538
Dmitrovic R (2000) Transvaginal color Doppler study of uterine blood flow in primary dysmenorrhea. Acta Obstet Gynecol Scand 79:1112–1116. doi:10.1034/j.1600-0412.2000.0790121112.x
Ducsay CA, McNutt CM (1989) Circadian uterine activity in the pregnant rhesus macaque: do prostaglandins play a role? Biol Reprod 40:988–993. doi:10.1095/biolreprod40.5.988
Zaidi J, Jurkovic D, Campbell S, Pittrof R, McGregor A, Tan SL (1995) Description of circadian rhythm in uterine artery blood flow during the peri-ovulatory period. Hum Reprod 10:1642–1646
Lundstrom V, Eneroth P, Swahn ML (1984) Diurnal variation of uterine contractility. Br J Obstet Gynaecol 91:155–159
Sundell G, Milsom I, Andersch B (1990) Factors influencing the prevalence and severity of dysmenorrhoea in young women. Br J Obstet Gynaecol 97:588–594
Rawling MJ, Wiebe ER (2001) A randomized controlled trial of fentanyl for abortion pain. Am J Obstet Gynecol 185:103–107. doi:10.1067/mob.2001.115860
Smith RP (1993) Cyclic pelvic pain and dysmenorrhea. Obstet Gynecol Clin North Am 20:753–764
Eden JA (1998) Dysmenorrhea and premenstrual syndrome. In: Hacker NF, Moore JG (eds) Essentials of obstetrics and gynecology, 3rd edn. WB Saunders, Philadelphia, pp 386–392
Akerlund M (1979) Pathophysiology of dysmenorrhea. Acta Obstet Gynecol Scand Suppl 87:27–32
Akerlund M (2002) Involvement of oxytocin and vasopressin in the pathophysiology of preterm labor and primary dysmenorrhea. Prog Brain Res 139:359–365. doi:10.1016/S0079-6123(02)39030-7
Laudanski T, Kostrzewska A, Akerlund M (1984) Interaction of vasopressin and prostaglandins in the nonpregnant human uterus. Prostaglandins 7:441–452. doi:10.1016/0090-6980(84)90202-8
Yambe Y, Arima H, Kakiya S, Murase T, Oiso Y (2002) Diurnal changes in arginine vasopressin gene transcription in the rat suprachiasmatic nucleus. Brain Res Mol Brain Res 104:132–136. doi:10.1016/S0169-328X(02)00327-3
Fraser IS (1992) Prostaglandins, prostaglandin inhibitors and their roles in gynaecological disorders. Baillieres Clin Obstet Gynaecol 6:829–857. doi:10.1016/S0950-3552(05)80191-9
Klein JR, Litt IF (1981) Epidemiology of adolescent dysmenorrhea. Pediatrics 68:661–664
Dawood MY (1984) Ibuprofen and dysmenorrhea. Am J Med 77:87–94
Harel Z (2006) Dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol 19:363–371
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Celik, H., Gurates, B., Parmaksiz, C. et al. Severity of pain and circadian changes in uterine artery blood flow in primary dysmenorrhea. Arch Gynecol Obstet 280, 589–592 (2009). https://doi.org/10.1007/s00404-009-0966-7
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DOI: https://doi.org/10.1007/s00404-009-0966-7