New Drug for Easing Menstrual Cramps Promising

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A new drug that has completed Phase I clinical trials and is entering Phase II is showing promise as a relief for painful menstrual cramps that affect millions of women worldwide. The drug, known as VA111913, works by targeting the cause of the cramps rather than just easing the pain.

Menstrual cramps, called dysmenorrhea, affects between 45 and 90 percent of women of child-bearing age and are caused when the smooth muscles of the uterus contract with increasing frequency. The drug targets and blocks a hormone called vasopressin, a powerful stimulatn of the uterus particularly at the onset of menstruation. Circulating levels of vasopressin are four times higher in women with dysmenorrhea than in asymptomatic women.

The most common symptoms of dysmenorrhea are abdominal and back pain. Severe cramping can also cause nausea, vomiting, sweating, and dizziness. Current treatments include pain relievers and anti-inflammatory drugs. Some women are also prescribed hormonal birth control that can stop ovulation and reduce the severity of the cramping. Unfortunately, these treatments are ineffective in about one-third of women with moderate or severe cases.

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"We hope that the drug will provide a more effective treatment option for millions of women worldwide with this painful condition," says researcher Andrzej R. Batt of Vantia Ltd., the U.K.-based pharmaceutical company that is developing and testing the drug. "Dysmenorrhea not only diminishes the quality of life for millions of women, but also has a hidden, society-wide economic cost that involves an enormous number of days lost from work and school."

Batt presented his research at the 239th annual meeting of the American Chemical Society in San Francisco. The results of Phase II trials are expected to be released later this year. If those results confirm the initial findings, phase III clinical trials will then commence. It could be about four years before the drug reaches the FDA for approval and distribution.

Until the drug is available, women who have severe menstrual cramps are offered these current treatments:

 NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be helpful in relieving the pain of menstrual cramps. Over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve) can start the day before your period begins. Prescription NSAIDs, such as mefenamic acid (Ponstel), are also available.
 Soaking in a hot bath or using a heating pad on your lower abdomen appears to be just as effective as over-the-counter pain medication for relieving menstrual cramps.
 Stress reduction. Activities that reduce stress — such as yoga, massage and meditation — may help ease the pain of menstrual cramps.
 Acupuncture. Acupuncture has been used in China to relieve pain for more than 2,000 years. A practitioner places hair-thin needles into the skin at specific places on your body. Most people feel no pain when the needles are inserted.
 TENS. Transcutaneous electrical nerve stimulation (TENS) has been found to be more effective than placebo in relieving the pain associated with menstrual cramps. A TENS device raises the threshold for pain signals and stimulates the release of endorphins, your body's natural painkillers.
 Dietary supplements. Some studies have indicated that vitamin E, thiamin and omega-3 supplements may help reduce menstrual cramps.

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