Pain can typically last 12 to 72 hours, and patients might have other symptoms, such as nausea and vomiting, fatigue and diarrhoea. Primary dysmenorrhoea refers to recurrent pain, while secondary dysmenorrhoea results from reproductive system disorders.
Pain from secondary dysmenorrhoea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. Hormonal contraception methods that contain oestrogen and progestin, such as the pill, the patch, and the vaginal ring, can be used to treat painful periods. Birth control methods that contain progestin only may also reduce period pain.
Dydrogesterone is a retro-progesterone preparation widely used for over a half-century. Taniguchi et al sought to evaluate the efficacy and safety of dydrogesterone in Japanese women with dysmenorrhoea.
This study was conducted as an open-label, single-arm, multicenter study. One dydrogesterone 5mg tablet was administered orally twice daily for 21 days from the 5th to 25th day of each menstrual cycle. A total of 44 (safety analysis) and 31 patients (efficacy analysis) were enrolled.
Total dysmenorrhoea score, dysmenorrhoea subscale scores, dysmenorrhoea visual analogue scale, severity of menstruation-related lower abdominal pain, low back pain, headache, and nausea/vomiting, basal body temperature, and serum oestradiol and progesterone levels were evaluated.
Baseline of the total dysmenorrhoea score was 4.61, which declined over time following the administration of dydrogesterone, and the decrease was statistically significant at and after 2nd cycle of menstruation.
Mean change from baseline at the final evaluation point was −1.84 (P < 0.001). Severity of menstruation-related lower abdominal pain, low back pain, headache, and nausea/vomiting, in the evaluated menstruation cycles tended to decrease over time. Basal body temperature showed a biphasic pattern in 70% at baseline, 50% in second menstruation cycle, and 61% in fifth menstruation cycle, and at least half of the patients may have had ovulation during the treatment. Incidence of adverse drug reactions was 31%, and the most common adverse event was metrorrhagia.
The study authors concluded that dydrogesterone is efficacious, safe, and clinically beneficial in patients with dysmenorrhoea, thereby indicating that dydrogesterone can be considered as a treatment option for patients with this often debilitating condition.
Taniguchi F, Ota I, Iba Y et al. The efficacy and safety of dydrogesterone for treatment of dysmenorrhea: An open-label multicenter clinical study. J. Obstet. Gynaecol. Res. 2019;45:168-175. https://doi.org/10.1111/jog.13807.