Besides progesterone's ability to cause fluid retention (plus many other undesirable side effects), it also appears to have the ability to spark off the production of another hormone, this time produced by the uterus itself. As more and more progesterone is formed during the latter part of the menstrual cycle, progressively increased amounts of the other hormone are also manufactured. Its name is prostaglandin. Only in the past few years has it been recognized as being in the system; in fact, it is the major hormonal discovery of recent times.

Prostaglandin was originally believed to be produced solely in the prostate, a gland in males situated just under the bladder. The prostate helps manufacture fluid that later becomes the fluid pan of seminal fluid in which the sperms are carried.

But recent research has shown that prostaglandins are manufactured in many different organs of the body, even including the lung and the uterus. So they are not entirely a 'man-made' chemical. No, sir. They are very much 'hers' as well. And here is where problems lie.

One of the properties of prostaglandin is to cause muscle contraction. So, as the menstrual cycle winds on, more and more of it appears in the uterine walls. Then at the climax, when a period is about to commence, the full effect of its presence becomes manifests.

It produces considerable and strong contractions of the muscle fibres of the uterine wall. Maybe it is there to help expel the unwanted by-products of the endometrial lining breakdown, which is what menstruation really is. In any case, the contracting muscles certainly cause a great deal of discomfort.

And that, in essence, is the way we now believe the pelvic pain called dysmenorrhoea occurs. All the talk of yesteryear about pelvic congestion (whatever that meant, presumably a damming up of blood in the pelvis somewhere) is now old hat. The prostaglandin theory dominant, and it is more likely to be the true situation.

Treatment has likewise taken a dramatic turn for the better, much to the delight and joy of the sufferers. Today there is a well-established battery of drugs, which are named 'prostaglandin antagonists'. These, as their name implies reverse the effect of prostaglandin. The way they do this is complex-they prevent the formation of a special enzyme which in turn produces the hormone itself. But here we will not spend time going into the complicated mechanics, for they do not really matter.


Women's health

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