Pathogenic basis for the use of a combined analgesic for pain relief in primary dysmenorrhea
Dysmenorrhea is a complex of symptoms that most commonly occurs a day before or on the first day of menstruation. This paper describes in detail risk factors and prevalence of the primary and secondary dysmenorrhea. The authors discuss the etiology and pathogenesis of period pain, the mechanism of analgesic action of combined analgesic, and its use for primary dysmenorrhea depending on its severity. Systematic reviews of the comparative analysis of the efficacy of management strategies for primary dysmenorrhea have demonstrated that NSAIDs are beneficial for moderate-to-severe pelvic pain. A broad effect of NSAIDs on pain relief is mediated by reducing the production of prostaglandins (inflammatory mediators). NSAIDs or antispasmodics are most commonly used to reduce dysmenorrhea symptoms. Russian scientists focus on fixed-dose combinations of NSAIDs and myotropic antispasmodics, e.g., ibuprofen, pitofenone hydrochloride (myotropic antispasmodic), and fenpiverinium bromide (M-cholinoblocker with central and peripheral action). The pathogenic basis for the use of this combination for primary dysmenorrhea is addressed.