الفهرس 
DysmenorrheaOnly 14 pages are availabe for public view
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Abstract
Primary dysmenorrhea is one of the most common gynecological problems among women in the reproductive age and defined as painful menstrual cramps without any evident pathology to account for them. Current understanding implicates an excessive imbalanced amount of prostanoids and possibly eicosanoids released from the endometrium during menstruation. The uterus is induced to contract frequently and dysrhythmically, with increased basal tone and increased active pressure. Uterine hypercontractility, reduced uterine blood flow, and increased peripheral nerve hypersensitivity induce pain. Diagnosis rests on a good history with negative pelvic evaluation findings.
Evidence-based data support the efficacy of cyclooxygenase inhibitors, such as ibuprofen, naproxen sodium, and ketoprofen, and estrogen-progestin oral contraceptive pills (OCPs). Cyclooxygenase inhibitors reduce the amount of menstrual prostanoids released, with concomitant reduction in uterine hypercontractility.
This study was done during the period of 2013 - 2014 at Ain shams university maternity hospital. It looked at the evaluation and comparison of the efficacy of Xysmalobium undulatum (L.) -Uzara and ibuprofen on uterine blood flow in moderate and severe cases of primary dysmenorrhea.
After their verbal approval of patients who attended outpatient clinics in Ain Shams University Maternity Hospital, during the period of the study. They received a questionnaire, This was completed with the help of instructions given by the investigators who was fully aware of the objectives of the study.
The questionnaire looked at demographic data, including family history of dysmenorrhea, some biological factors including age at menarche, duration and amount of the cycle, use of analgesia or medications for dysmenorrhea and their effectiveness and presence of associated symptoms. It also looked at the percent of the participants seeking medical advice. The pain intensity was measured by the visual analogue scale (VAS), verbal rating scale (VRS).
Sixty patients who had moderate or severe dysmenorrhea were recruited and counseled for participation. A written consent was obtained from them and they were randomly assigned for the intake of Uzara or ibuprofen in study. On the first day of the cycle, they attended to the ultrasound unit and were asked to report the intensity of pain and the associated symptoms, if any . Then they had a trans vaginal scan(TVS) done both to exclude any apparent pelvic pathology and measure the uterine Doppler indices. They were then asked to take either Uzara or Ibuprofen according to the randomization plan and then had another trans-vaginal scan (TVS) to repeat measuring the Doppler indices. They were also asked to record their VAS after treatment and any symptoms or side effects.
The results showed the significantly improved Doppler indices after both medications together with the correlated improvement of the VAS scores.
Uzara was well tolerated with minimal side effects and ibuprofen had mainly been associated with gastero intestinal side effects.
The action of uzara is thought to be through inhibition of smooth muscles of the myometrium with involvement of sympathetic system and increase uterine blood flow; as these contractions are thought to cause dysmenorrheal pain, a mechanism closely similar to that of beta-adrenergic sympathomimetics being tried for treating dysmenorrhea.
NSAIDs are considered the first line of treatment in primary dysmenorrhea, yet they are well known for the occurrence of side effects and they have also their list of contraindications. Also failure of treatment with them was reported in about 25%. Thus with the presence of a contraindication, side effects, or a failure to respond to NSAIDs, women may need to look for alternative treatments. so Uzara is useful, safe and effective option.