Investigational drugs for the treatment of dysmenorrhea

ABSTRACT

Introduction

Dysmenorrhea is the most common cause of gynecological pain among women that has considerable impact on quality of life and psychosocial wellbeing. Non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies are most commonly used to treat dysmenorrhea. However, given these drugs are often associated with bothersome side effects and are less effective when there is an underlying cause contributing to dysmenorrhea (e.g. endometriosis), a patient-centered approach to managing dysmenorrhea is important. Various new drugs are currently being investigated for the treatment of primary and secondary dysmenorrhea.

Areas covered

This review provides an updated overview on new therapeutic targets and investigational drugs for the treatment of primary and secondary dysmenorrhea. The authors describe the clinical development and implications of these drugs.

Expert opinion

Among the investigative drugs discussed in this review, anti-inflammatories show the most promising results for the treatment of dysmenorrhea. However, given some trials have considerable methodological limitations, many drugs cannot be currently recommended. Research focused on understanding the mechanisms involved in menstruation and its associated symptoms will be important to identify new therapeutic targets for dysmenorrhea. Further robust clinical trials are required to better understand the efficacy and safety of investigational drugs for treating primary and secondary dysmenorrhea.

KEYWORDS:

• Anti-inflammatories
• dysmenorrhea
• endometriosis
• hormonal therapy
• medical therapy

Article highlights

• Current medical treatments for dysmenorrhea are associated with bothersome side effects and limited efficacy.

• Hormonal therapies, anti-inflammatories, cannabinoids, complementary therapies, anti-angiogenic, and glycolysis inhibitor drugs are currently being investigated for primary and secondary dysmenorrhea.

• Due to the limited quality and quantity of evidence, the investigational drugs cannot be currently implemented clinically, and further research is required to better understand their efficacy and safety.

Declaration of interests

Amelia Mardon has received payments and been reimbursed travel costs for presenting on pelvic pain at scientific conferences/symposia. Mike Armour is an advisory board member for Evolv Health. He is the lead investigator on several clinical studies on medicinal cannabis for primary and secondary dysmenorrhea, funded by philanthropic donors, government, and University partnership grants. All other authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.