Nitroglycerine dermal patch for severe dysmenorrhea: In vitro and clinicalresults

Objective: To evaluate (I) the effect of nitroglycerine on the contractilit y of nonpregnant uterine tissue in vitro and (II) the results and side effe cts of transdermal nitroglycerine in patients with severe dysmenorrhea. Methods: I. 40 myometrial strips were obtained from 15 hysterectomy specime ns and placed in an organ bath. Nitroglycerine was added at different conce ntrations (1.7 x 10(-8) to 5.8 x 10(-4) mol/L) and changes in motility and the frequency of isometric contractions were measured. II. 20 patients with severe dysmenorrhea applied a nitroglycerine-releasing dermal patch on the lower abdomen with (n = 10) or without ibuprofen (n = 10; 400 mg PO). Bloo d pressure was measured every 15 min for 1 hour, side effects were noted, a nd the patient rated the effectiveness of the patch on a scale (0 = no chan ge to 3 = complete resolution). Results: I. In vitro nitroglycerine significantly reduced or eliminated the contractility of myometrial strips. II. The mean improvement rate of patie nts receiving nitroglycerine with or without ibuprofen was 2.8 and 2.0, res pectively. Patients receiving nitroglycerine with ibuprofen had a significa nt decrease in systolic blood pressure at 15 minutes. Headache was reported by 4 of the 10 patients receiving nitroglycerine alone and none of the oth er group. Conclusion: Transdermal nitroglycerine is a treatment option for patients w ith severe dysmenorrhea. The incidence of headache associated with nitrogly cerine treatment appears to be reduced with concomitant ibuprofen.