Could Viagra really be used to treat period pain?

Since it burst onto the market in 1998, sildenafil citrate (sold under the brand name Viagra at the time), has injected a boost into the love lives of couples around the world.

In the subsequent 15 years, the treatment has been explored for other purposes besides erectile dysfunction and has been found to be effective for pulmonary hypertension (marketed under the name Revatio for this condition).

Moreover, clinical trials have shown the impotence drug to be beneficial for people with raynaud’s phenomenon, with Viagra helping blood supply to the fingers, toes, or both, which become pale, cold, and painful, and Viagra has also shown to have an impact in high altitudes for mountain sickness, enabling people to exercise in places with a low level of oxygen.

However, a team of researchers have now discovered yet another troublesome health complaint that sildenafil may work wonders for, and shockingly it is not a male-related problem. Yes fellas, soon you may find yourself having to share your little blue pills with the other half!

Penn State College of Medicine researchers joined forces with fellow researchers at Nova Gradiska General Hospital in Croatia, who assessed 25 women, aged between 18 and 35, all experiencing primary dysmenorrhea at moderate to severe levels.

Dysmenorrhea – more often simply known as ‘painful periods’ can be segregated into primary and secondary dysmenorrhea, with primary being the most common. This is where there is no underlying problem of the womb, usually afflicting teenagers and women in their early 20s.

Symptoms of primary dysmenorrhea are commonly felt after around 6 to 12 months of periods that are painless, with many women feeling a cramp in their lower abdomen, back and thighs. Sometimes this is accompanied with a feeling of fatigue, nausea, diarrhoea and vomiting. Many women find their menstrual cramps start about 1 or 2 days after bleeding.

Unless the cause is related to an underlying health condition, the majority of cases of primary dysmenorrhea occur when the blood supply to the womb has been stopped because the muscular wall of the womb has contracted. With no oxygen, the tissues in the womb emit chemicals that are responsible for the pain that follows.

For the study, the participants were randomly selected to either receive a dose of 100mg sildenafil citrate, administered vaginally for the purpose of the study, or a placebo. Over the next 4 hours the women then documented any improvements in respect of their pain subsiding.

Generally, it was found that those who received the sildenafil citrate reported less pain compared to the women taking a placebo, with no side effects.  The researchers involved in the study say that the increase in blood flow is most likely causing the alleviation of pain, but because both the sildenafil and placebo increased, they admit they are not certain of the exact reason for the sildenafil decreasing the pain.

“If future studies confirm these findings, sildenafil may become a treatment option for patients with PD [primary dysmenorrhea],” study researcher Richard Legro, a professor of obstetrics and gynecology and public health sciences at the university, said in a statement.

Professor Legro added: “Since PD is a condition that most women suffer from and seek treatment for at some points in their lives, the quest for new medication is justified.” Currently, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are usually the preferred choice to ease the pain associated with severe menstrual cramps.

Female oral contraceptive pills could alleviate menstrual cramps

Oral contraceptive pills such as Dianette are taken by women for everyday for 21 days of their menstrual cycle, followed by a 7 day break when no pills are taken at all (also known as ‘cyclic treatment’). During this one week time period, women are still protected against unwanted pregnancies. In the 7 day rest period, hormone levels in the blood begin to decrease and women will experience a withdrawal bleed that is just like a normal period. Regardless of bleeding, the next pack of 21 tablets is begun after the week is up.

However, some experts are now claiming that women could see health benefits from taking the oral contraceptive pills uninterrupted throughout the menstrual cycle instead of adhering to the usual 21 day block. Specifically, the scientists involved in the study into oral contraceptive pills, allege that this continuous usage can provide women with earlier relief from the symptoms of dysmenorrhea.

Dysmenorrhea is one of the most gynaecologic complaints amongst younger women, with an estimated three quarters of them suffering from such problems and the term can basically be defined as ‘painful periods’. For roughly a fifth of women, the pains are so severe and unbearable that it can actually prevent them from going about their day to day activities. Dysmenorrhea happens during menstruation and is thought to occur because of three main reasons; unusual uterine contractions, more pressure on the pelvic region and a heightened sensitivity to pain.

Dr Richard Legro, professor of obstetrics and gynaecology at Penn State College of Medicine, says, “Between 50 and 90 percent of women suffer from this condition, and it can really limit work, school, or athletic performance. Previous studies have estimated that dysmenorrhea accounts for 600 million lost work hours and $2 billion annually.”

The women involved in Dr Legro’s study, were all experiencing inexplicable menstrual pain. This means that health experts could not pinpoint their pains to typical common problems such as ovarian cysts, endometriosis, any past surgical procedures, or other pelvic or bowel diseases.

Dr Legro commented on the aims of his study and said, “Oral contraceptives are often prescribed to treat this condition (dysmenorrhea), since reducing menstruation is a relatively straightforward way to relieve this cramping. However, we wanted to determine whether there was a measurable difference between cyclic and continuous oral contraceptive treatment methods.”

To judge the effects of a cyclic course of treatment vs. a continuous method of taking the contraceptive pills, Dr Legro split the female subjects into two groups and each group spent half a year on that particular therapy. After the evaluation, it was discovered that both groups had actually seen a decline in menstrual pain over this time. Interestingly though, the group assigned the continuous treatment, overall stated they had experienced substantial pain relief earlier on compared to the others.

Despite the promising indications shown in this study, Medical Specialists Pharmacy do not advise women who are taking Dianette to make any alterations to the recommended course of treatment before consulting their own GP first. We believe further analysis is warranted to fully determine the risks and benefits involved with continuously taking oral contraceptive tablets.