The effect of pycnogenol on patients with dysmenorrhea using low-dose oral contraceptives

The effect of pycnogenol on patients with dysmenorrhea using low-dose oral contraceptives

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Hugo Maia Jr, Clarice Haddad, Julio Casoy Centro de Pesquisa e Assistência em Reprodução Humana (CEPARH), Salvador, Bahia, BrazilObjective: Menstrual symptoms such as dysmenorrhea usually occur during the hormone-free interval in oral contraceptive users.Progestin withdrawal activates NF-κB transcription factor, which upregulates both vascular endothelial growth factor (VEGF) and Cox-2 expression in the endometrium.The use of natural NF-κB inhibitors such as pycnogenol may block this response, improving dysmenorrhea.Patients and methods: Twenty-four patients with severe dysmenorrhea were allocated to one of two treatment groups.

In Group A (n=13), women were treated with an oral contraceptive containing 15 µg of ethinyl estradiol and 60 mg of gestodene (Adoless®) in a white ice laminate countertop 24/4 regimen for three consecutive cycles.Women in Group B (n=11) used the same contraceptive regimen together with 100 mg of pycnogenol (Flebon®) continuously for 3 months.Pain scores were graded using a visual analog scale (VAS) before and during the hormone-free interval at the end of the third treatment cycle.Results: Before treatment, VAS pain scores for dysmenorrhea were 8 and 9 in Groups A and B, respectively.

However, by the end of the third treatment cycle, pain scores had decreased significantly (P<0.05) both in groups A and B.The final pain scores were army meritorious civilian service medal 6 in Group A and 2 in Group B, a difference that was statistically significant (P<0.0001).

In Group B, 27% of the patients became pain-free, while in Group A, none of the women reported complete disappearance of this symptom.The number of bleeding days was also lower in Group B.Discussion: Pycnogenol effectively decreased pain scores and the number of bleeding days when administered concomitantly with a low-dose 24/4 oral contraceptive containing gestodene.Keywords: gestodene, hormone-free interval, pain.