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- Bexelius, Maria, et al.
(author)
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27 forskare : Så kan EU:s murar rivas
- 2015
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In: Dagens samhälle. - : Sveriges kommuner och landsting. - 1652-6511. ; :20150923
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Journal article (pop. science, debate, etc.)
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- Söderman, Lisa, et al.
(author)
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Adjuvant use of melatonin for pain management in dysmenorrhea - a randomized double-blinded, placebo-controlled trial
- 2022
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In: European Journal of Clinical Pharmacology. - : Springer Heidelberg. - 0031-6970 .- 1432-1041. ; 78:2, s. 191-196
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Journal article (peer-reviewed)abstract
- Purpose Dysmenorrhea is a common, recurring, painful condition with a global prevalence of 71%. The treatment regime for dysmenorrhea includes hormonal therapies and NSAID, both of which are associated with side effects. A dose of 10 mg melatonin daily has previously been shown to reduce the level of pelvic pain in women with endometriosis. We chose to investigate how this regime, administered during the week of menstruation, would affect women with dysmenorrhea but without any signs of endometriosis, as adjuvant analgesic treatment. Methods Forty participants with severe dysmenorrhea were randomized to either melatonin or placebo, 20 in each group. Our primary outcome was pain measured with numeric rating scale (NRS); a difference of at least 1.3 units between the groups was considered clinically significant. Secondary outcomes were use of analgesics, as well as absenteeism and amount of bleeding. Mixed model was used for statistical analysis. Results Eighteen participants completed the study in the placebo group and 19 in the melatonin group. Mean NRS in the placebo group was 2.45 and 3.18 in the melatonin group, which proved to be statistically, although not clinically significant. Conclusion This randomized, double-blinded, placebo-controlled trial could not show that 10 mg of melatonin given orally at bedtime during the menstrual week had better analgesic effect on dysmenorrhea as compared with placebo. However, no adverse effects were observed.
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| 4. |
- Söderman, Lisa
(author)
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Pelvic pain due to endometriosis and dysmenorrhea
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Background: Approximately 70% of women in reproductive age suffer from dysmenorrhea around the world but no prevalence study has been made in Sweden for 35 years. Dysmenorrhea, painful menstruation, can be a sign of endometriosis which for many is a disabling disease due to pelvic pain but also symptoms from the gastrointestinal tract, the bladder, fatigue and infertility. Treatment options for this chronic inflammatory disease as well as for dysmenorrhea are pain killers and hormonal therapy to suppress the menstrual cycle, and for endometriosis sometimes surgery. But these treatment options are not suited for everybody and are often associated with adverse effects. Preclinical trials have shown that melatonin has analgesic and anti-oxidative properties. Melatonin has shown to reduce the size of endometriotic implants in rodents. A clinical trial has showed melatonin to reduce endometriosis-associated pain more effectively than placebo. Aim: To investigate the prevalence of dysmenorrhea and its impact on the life of young women in Stockholm; To investigate the analgesic effect of melatonin on severe dysmenorrhea and endometriosis-associated pain respectively, compared to placebo. A significant clinical effect was set to a reduction of 1.3 units on the numeric rating scale. Materials, methods and results: Three studies were conducted during 2017-2021. Study I is a cross-sectional study. A questionnaire was sent out to all women born in the year 2000 and residing in Stockholm (n= 3998). With a response rate of 45%, the prevalence of dysmenorrhea was 89% (1580 of 1785, 95% CI 87‐90), out of which 36% (574 of 1580, 95% CI 34‐39) reported severe dysmenorrhea. High rates of fatigue (83%) and headache (82%) were observed, 14% reported monthly absenteeism and the tendency to seek medical care was low as only 7% had seen a doctor. Studies II and III are placebo-controlled, randomized trials with 40 women in each trial, 20 were allocated to placebo and 20 to melatonin. In Study II women with severe dysmenorrhea received 10 mg melatonin or placebo at bedtime for the week of menstruation during two menstrual cycles. No superior analgesic effect was seen with melatonin compared with placebo. In study III women with endometriosis-associated pain received 20 mg melatonin or placebo at bedtime for two consecutive menstrual cycles or months. No superior analgesic effect was seen with melatonin compared with placebo. Conclusions: The prevalence of dysmenorrhea in Stockholm is high with substantial implications on the daily lives of young women. The low tendency to seek medical care suggests a normalization. Our chosen dose and regime could not show any analgesic effect superior to placebo, future studies are needed to investigate other doses and regimes that could be of use as adjuvant treatment of dysmenorrhea and endometriosis-associated pain.
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