Clinical Research Directory

Mechanistic Characterization of Uterine Pain

There are limited treatment options for management of dysmenorrhea, and the physiological processes they affect are not completely understood. For example, NSAIDs are effective in reducing menstrual pain in some women by inhibition of prostaglandin synthesis, but whether those effects are mediated by affecting contractility, perfusion, or hypoxemia is unknown. Understanding how these drugs relieve menstrual pain (and why they fail) would be of substantial clinical significance. Given the foregoing, Two Specific Aims are proposed: Aim #1: Characterize menstrual pain phenotypes associated with impairments in myometrial activity, perfusion, and/or oxygenation. Continuous MRI scans of the uterus will be performed with simultaneous measurement of self-reported pain in healthy women and those experiencing menstrual pain. The investigators will include cohorts of women with imaging diagnosed leiomyoma and surgically-confirmed endometriosis to evaluate the contribution of structurally identifiable factors. Based on preliminary data, the investigators anticipate finding four phenotypes with menstrual pain related to: 1) myometrial activity, 2) inadequate perfusion and/or oxygenation, 3) a combination of phenotypes 1 \& 2, and 4) a non-uterine source. Aim #2: Evaluate the effects of naproxen on myometrial activity, perfusion, and/or oxygenation with respect to pain relief. In women with primary dysmenorrhea, the investigators will acquire pelvic MRI scans and evaluate self-reported menstrual cramping pain before and after administration of randomized naproxen or placebo. Naproxen could principally affect one or more potential sources of uterine pain such as myometrial activity, perfusion, and/or oxygenation. The investigators will corroborate preliminary data findings, which suggest menstrual phenotypes with myometrial activity will be more likely to respond. Conversely, Aim 2 will also elucidate the mechanisms responsible for inadequate pain relief from naproxen. Bioavailability of naproxen levels and other molecules associated with NSAID-resistance will be evaluated from the serum of participants after taking naproxen using HPLC-MS.

The Effect of SuJok Application on Dysmenorrhea and Quality of Life in Young People With Primary Dysmenorrhea:

Menarche, which is one of the most prominent features of maturation in adolescents and the transition from childhood to adulthood, causes many problems. The most prominent of these complaints is dysmenorrhea. Primary dysmenorrhea, the most common form of dysmenorrhea, is a gynecological disorder characterized by pain that starts in the lower abdomen before or during menstruation and radiates to the waist and legs. Primary dysmenorrhea is seen especially in women under 25 years of age and within 6-12 months after menarche. Dysmenorrhea is a preventable and treatable disease. There are pharmacologic and nonpharmacologic methods in the treatment of dysmenorrhea. Pharmacologic methods include NSAIDs and hormonal contraceptives. Nonpharmacological methods used in the treatment of dysmenorrhea include hot application, regulation of nutrition, relaxation exercises, massage, yoga, reflexology, acupuncture, acupressure, TENS method, vitamins B and E, calcium, magnesium, zinc supplements, fennel and rose teas, ginger, aromotherapy applications. In addition to pharmacological methods, nonpharmacological methods are frequently used in the treatment of dysmeorrhea. People have recently turned to alternative medicine in the treatment of diseases in order to get rid of the side effects of drugs. Today, medicine is constantly developing and new treatment options are emerging. The treatment method that has recently started to be used and its effect has been seen is SuJok therapy. SuJok therapy was developed in 1986 by South Korean scientist Professor Park Jae Woo. In Korean, "Su" means hand and "Jok" means foot. In SuJok therapy, hands and feet are used as a treatment method. In SuJok, the hands and feet are a miniature replica of the body and have maximum structural similarity to the human body in anatomical terms. Every organ in our body has reflection points on the hands and feet. Thus, it activates all organs in our body with hands and feet. With the SuJok therapy method, it is argued that by using various techniques with the reflections of the body in the hand and foot points of the body, the organ and body area are physically stimulated and the energy in the body is activated and healing occurs. In the literature, studies on SuJok therapy applications are limited and there are no studies showing the effect of SuJok application on primary dysmenorrhea.