Differential suppression of menstrual fluid prostaglandin F2a, prostaglandin E2, 6-keto prostaglandin F1a and thromboxane B2 by suprofen in women with primary dysmenorrhea

Eleven women with primary dysmenorrhea completed a randomized, double-blind, placebo-controlled, three-way cross-over study comparing 200 and 400 mg suprofen. Menstrual fluid volume did not change. Mean ± S.E.M. menstrual fluid PGF2a was significantly suppressed from 18.9 ± 1.9 μg (placebo) to 10.9 ± 1.7 and 9.3 ± 2.1 μg with 200 and 400 mg suprofen, respectively (p = <0.005). PGE2 dropped from 7.8 ± 0.9 to 4.6 ± 0.8 and 4.6 ± 1.1 μg (p = <0.05) and TxB2 from 17.5 ± 4.3 to 7.5 ± 2.9 and 3.6 ± 1.3 μg (p = <0.01), respectively. 6-Keto PGF1a was significantly suppressed (2.7 ± 0.4 to 1.9 ± 0.5 μg, p = <0.025) with only 400 mg suprofen. Six subjects rated placebo poor and five fair to very good. In contrast, nine rated suprofen excellent to fair while two rated poor. Thus, suprofen was clinically effective but the differential suppression of prostanoids favors 200 mg which spares 6-keto PGF1a.