Primary Dysmenorrhea in Relation to Oxidative Stress and Antioxidant Status: A Systematic Review of Case-Control Studies

Abstract

Primary dysmenorrhea is defined as painful menstrual cramps of uterine origin in the absence of pelvic pathology and is the most common gynecological disorder among women of reproductive age. The aim of this study was to systematically review case-control studies that have investigated the oxidative stress, antioxidant status, and inflammation markers among women with primary dysmenorrhea and controls. The study protocol was registered with PROSPERO (no. CRD42020183104). By searching PubMed and Scopus databases as well as reference lists, six case-control studies with fifteen eligible markers (seven oxidative stress, seven antioxidant status, one inflammation) were included in this review. The quality of the included studies was assessed as medium or high. The systematic review included 175 women with primary dysmenorrhea and 161 controls. The results indicate an elevated level of oxidative stress, especially of lipid peroxidation among dysmenorrheal women. For the antioxidant status, limited evidence was found for a lower status among primary dysmenorrhea women, and only one study examined one inflammation marker (hs-CRP), which makes it impossible for such a conclusion. To establish whether oxidative stress, antioxidant status or inflammation participate in the pathophysiology of primary dysmenorrhea, high-quality studies with larger study groups and clear case definitions are needed.

Is Premenstrual Syndrome Associated with Inflammation, Oxidative Stress and Antioxidant Status? A Systematic Review of Case–Control and Cross-Sectional Studies

“…In another study, PMS women had a statistically significantly elevated DNA damage marker (urine 8-hydroxy-2-deoxyguanosine) compared to controls [ 34 ]. A higher level of oxidative stress occurs also in another menstrual cycle abnormality—primary dysmenorrhea, which was especially evident for lipid peroxidation markers [ 35 ].…”

An Evaluation of the Effectiveness of Ibuprofen and Manual Therapy in Young Women with Dysmenorrhea—A Pilot Study

“…Prostaglandins lead to excessive contractile activity of the uterus, with the consequent hypoxia and pain [2]. In addition to prostaglandins, markers of inflammation and oxidative stress participate in the pathomechanism of dysmenorrhea [3,8].…”

Efficacy and safety of Chinese herbal footbaths for the treatment of dysmenorrhea: Protocol for a systematic review and meta-analysis

“…Increased PGs cause hypercontractility and hypoxia of uterine smooth muscle with decreased uterine blood flow and elevated sensitivity of peripheral nerves to pain [14]. Multiple factors such as vasopressin, oxytocin, calcium, oxidative stress, inflammation, and nitric oxide have also been implicated in the mechanism [15][16][17]. Currently, non-steroidal anti-inflammatory drugs (NSAIDs) are considered the first-line treatment for dysmenorrhea; however, they are ineffective for or intolerable by approximately 15% of patients and may cause gastrointestinal and neurological adverse effects and a higher risk of severe cardiovascular disease with long-term usage [18,19].…”