Action of a prostaglandin synthetase inhibitor on IUD associated uterine bleeding

Abstract

The Authors treated twenty-eight women using IUD, who suffered from increased menstrual blood loss and pelvic pain, with a prostaglandin synthetase inhibitor, Suprofen, in an attempt to reduce their symptomatology, in a double blind crossover study. The drug produced an important reduction of the menstrual blood loss and pains. These observations suggest that prostaglandins are involved in the etiology of excessive menstrual blood loss and pains, and that prostaglandin inhibitors may be useful for reducing these symptoms.

PIP: Suprofen (Suprol-Cilag S.p.A.), a prostaglandin synthetase inhibitor, was tested in a double-blind crossover design on 28 women whose IUDs caused them pain or increased menstrual bleeding. The subjects had worn either a Gravigard (18 women) or a Copper T (10) for 6 to 10 months. Each subject was observed for the first month, and took either placebo or Suprofen during the next menses, followed by the alternative for the third cycle. They took 20 mg Suprofen 4 times daily, at the first sign of bleeding and or pain, then 3 times daily thereafter, for the duration of symptoms or up to 7 days. Before treatment, 71% had severe bleeding, 18% had moderate bleeding and 11% had slightly increased bleeding. During Suprofen, 43% obtained a strong decrease in menstrual blood loss, 36% had a moderate decrease and 7% had a slight decrease. Placebo decreased bleeding moderately in 2. Pain was moderate to intense in 26 women and slight or none in 2 before treatment. With Suprofen, pain decreased moderately or greatly in 23 and slightly or not at all in 5 women. Placebo improved pain moderately in 1 subject. Reported side effects of the drug were stomach cramps in 1 and nausea and headaches in 2 women. In this study, when the subjects were categorized by degree of symptoms, the prostaglandin antagonist was more effective in those complaining of more severe bleeding and pain.