THE EFFECT OF NIMESULIDE AND NAPROXEN ON THE UTERINE AND OVARIAN ARTERIAL BLOOD-FLOW VELOCITY - A DOPPLER STUDY

Background. To measure the effect of oral naproxen and nimesulide trea tments on the uterine and ovarian arterial blood flow velocity in both eumenorrheic and dysmenorrheic women. Methods. The double-blind, plac ebo-controlled, study comprised six eumenorrheic women receiving eithe r placebo or nimesulide (100 mg, single oral dose) during two consecut ive cycles. Six women with moderate to severe dysmenorrhea were treate d with placebo, nimesulide or naproxen (500 mg, single oral dose) duri ng three consecutive cycles. Uterine impedance (pulsatile index, PI) w as measured during the cycle day 1 at four different levels of the ute rus and in the ovarian branch of the uterine artery at 0, 30, 60, and 120-140 min, with a color Doppler ultrasonograph for orientation and w ith pulsatile Doppler for recording waveforms. Results. In the eumenor rheic women no significant changes were found with any treatment. In d ysmenorrheic patients, nimesulide relieved symptoms and caused a decre ase in uterine artery PI earlier than naproxen. Both treatments reduce d the elevated uterine impedance in dysmenorrhea close to the normal l evel. When analyzing the PIs of the uterine artery at 4 different leve ls, the most prominent changes were observed in the fundus. The ovaria n branch remained unaffected. Conclusions. Color Doppler ultrasonograp hy and pulsatile Doppler are good methods for investigating disease- o r drug-induced changes in uterine and ovarian blood flow velocities. N imesulide induced a slightly faster and more complete decrease of the elevated uterine vascular resistance in dysmenorrhea, towards normal e umenorrheic levels, than naproxen. The fundal part of the uterus appea rs to be an important site of the pathogenesis in primary dysmenorrhea .