Abstract
Objective Primary dysmenorrhea occurs due to abnormal levels of prostanoids, uterine contractions,
and uterine blood flow. However, the reasons for pain in primary dysmenorrhea have
not yet been clarified. We examined the blood flow alterations in patients with primary
dysmenorrhea and determined the relationship between ischemia-modified albumin (IMA)
levels, as an ischemia indicator, and primary dysmenorrhea.
Methods In the present study, 37 patients who had primary dysmenorrhea and were in their
luteal and menstrual phase of their menstrual cycles were included. Thirty individuals
who had similar demographic characteristics, who were between 18 and 30 years old
and did not have gynecologic disease were included as control individuals. Their uterine
artery Doppler indices and serum IMA levels were measured.
Results Menstrual phase plasma IMA levels were significantly higher than luteal phase IMA
levels, both in the patient and in the control groups (p < 0.001). Although the menstrual phase IMA levels of patients were significantly
higher than those of controls, luteal phase IMA levels were not significantly different
between the two groups. Menstrual uterine artery pulsatility index (PI) and resistance
index (RI) of primary dysmenorrhea patients were significantly different when compared
with luteal uterine artery PI and RI levels. There was a positive correlation between
menstrual phase IMA and uterine artery PI and RI in the primary dysmenorrhea.
Conclusion Ischemia plays an important role in the etiology of the pain, which is frequently
observed in patients with primary dysmenorrhea. Ischemia-modified albumin levels are
considered as an efficient marker to determine the severity of pain and to indicate
ischemia in primary dysmenorrhea.
Keywords
ischemia-modified albumin - primary dysmenorrhea - uterine artery Doppler
