Modern approach to the treatment of early reproductive age women with primary dysmenorrhea

Dysmenorrhea is one of the most common gynecological disorders, which significantly worsens the quality of life of women of reproductive age. A characteristic manifestation of primary dysmenorrhea is painful spasms in the lower abdomen, which appear shortly before or at the beginning of menstruation and accompany its course in the absence of organic pathology of the pelvic organs.Among women of early reproductive age, the prevalence of dysmenorrhea is about 65%, and about 20% of women complain on the onset of its manifestations in adolescence, which has an extremely negative impact on the quality of life.The objective: to determine the effectiveness of magnesium preparations in the complex treatment of patients of early reproductive age with primary dysmenorrhea.Materials and methods. 51 women aged 18–24 years with clinical manifestations of primary dysmenorrhea were examined. They were divided into the main group and the comparison group at the stage of therapy.Women in the main group received a combined estrogen-gestagen drug containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone, in a cyclic regimen (24 + 4) in combination with a drug containing the chelated form of marine magnesium “Simag 55” 272 mg (purified natural marine mineral extract of magnesium) with two carriers (vitamin B6 – 2.7 mg and orotic acid – 25 mg) to ensure the highest bioavailability. The second drug was prescribed twice a day in the form of oral capsules for three months with a break of 3 months for 1 year.In order to assess the effectiveness of the proposed therapy all women filled out a visual analog scale (VAS) and underwent testing on the “WAM” scale on the first-second day of menstruation in the 1st, 6th and 12th months from the start of treatment.Results. The study of the intensity of menstrual pain according to VAS after 12 months from the start of treatment established an extremely weak intensity of pain (0–1 point) in the majority of patients in the main group – 16 (59.3%) (comparison group – 8 (33.3%); p < 0.05). In other women in the main group – 11 (40.7%) and the comparison group – 13 (54.2%), a weak intensity of menstrual pain was observed, the number of its cases did not have a significant difference (p > 0.05).After 12 months from the start of treatment on the background of a significant decrease in pain intensity, women in the main group indicated an average number of points that significantly exceeded the average number of points after 6 months from the beginning of treatment and the average number of points in women of the comparison group, for the block “Well-being” (the main group after 12 months from the beginning of treatment – 6.1 ± 0.3 points and after 6 months from the beginning of treatment – 5.3 ± 0.3 points, the comparison group – 5.2 ± 0.2 points; p < 0.05), the block “Activity” (the main group after 12 months from the beginning of treatment – 6.6 ± 0.2 points and after 6 months from the beginning of treatment – 5.7 ± 0.2 points, the comparison group – 5.5 ± 0.3 points; p < 0.05). This led to an increased average number of points for the “Mood” block (the main group after 12 months from the start of treatment – 7.1 ± 0.2 points and after 6 months from the start of treatment – 6.3 ± 0.3 points, the comparison group – 6.5 ± 0.2 points; p > 0.05).Conclusions. The use of the drug with the chelated form of marine magnesium “Simag 55” as part of the combined treatment for a year in patients of early reproductive age with primary dysmenorrhea leads to a significantly faster decrease in the intensity of menstrual pain was established from severe (6–8 points on VAS) – 17 cases (63.0%) and unbearable (8–10 points on VAS) – 10 (37.0%) to extremely weak (0–1 point on VAS) – 16 (59.3%) and weak (2–4 points on VAS) – 11 (40.7%) against the background of significantly better results according to the “WAM” questionnaire (block “Well-being”: the 1st month from the start of treatment – 2.1 ± 0.2 points, the 12th month from the start of treatment – 6.1 ± 0.3 points; block “Activity”: the 1st month from the start of treatment – 1.8 ± 0.3 points, the 12th month from the start of treatment – 6.6 ± 0.3 points; block “Mood”: the 1st month from the start of treatment – 2.0 ± 0.2 points, the 12th month from the start of treatment – 7.1 ± 0.2 points).The combined use of the drug, which includes magnesium “Simag 55” with combined estrogen-gestagen drugs is effective in the treatment of primary dysmenorrhea in patients of early reproductive age who do not have reproductive plans.