Primary dysmenorrhoea: the importance of both prostaglandins E2 and F2 alpha

Menstrual fluid was collected in a contraceptive diaphragm from 16 women with primary dysmenorrhoea and 12 matched control subjects without dysmenorrhoea. Prostaglandins F2 alpha (PGF2 alpha), E2 (PGE2) and 6-oxo-prostaglandin F1 alpha (6-oxo-PGF1 alpha) were extracted and measured using gas-chromatography: mass spectrometry (GC:MS). The concentrations of both PGF2 alpha and PGE2 were higher on days 1 and 2 in the dysmenorrhoea group than in the control group and the concentration of PGF2 alpha was higher on day 1 than on day 2 in the dysmenorrhoea group. The concentrations of 6-oxo-PGF1 alpha (the stable metabolite of PGI2) were low in both groups. These results confirm suggestions that PGF2 alpha is important in the aetiology of dysmenorrhoea and also indicate that PGE2 may be involved.     

Influence of prostaglandins F2alpha and E1 on vaginal contractility.

Sixty strips of vaginal wall obtained from 20 nonpregnant women (12 in the proliferative phase and 8 in the secretory phase of the menstrual cycle) were studied in vitro. Described and illustrated are 1) their spontaneous contractility, 2) enhancement of this by prostaglandin F2alpha, epinephrine, and norepinephrine, and 3) de novo induction of contractions by these agents. Contractility was inhibited and suppressed by prostaglandin E1, and after such suppression of norepinephrine-induced contractions they could not thereafter be reestablished by norepinephrine. The physiologic implications of these findings for the processes of reproduction are discussed.     

Induction of labor with the help of the prostaglandins E1, E2, F1alpha, and F2alpha

The authors report their experiences in inducing labour between the 34th and the 43rd week of amenorrhea by the administration of prostaglandins. The detailed results of several series are compared: PGF2alpha by venous perfusion alone (100 cases) or associated with buccal oxytocin (100 other cases), PGE1 by perfusion (25 cases), PGF2alpha and PGE2 by intra-amniotic injection in cases of fetal death (25 cases). After an extremely detailed discussion of the maternal and fetal results and of the secondary effects, the authors explain the indications, the means of introduction, and also the dosages. Finally they compare the effects of prostaglandins in full-term inductions and in so-called therapeutic abortions.     

Effect of prostaglandins E2 and 15-methyl F2 alpha on human pregnant and non-pregnant cervix

Forty-two women of reproductive age were studied in two equal groups (group I, first-trimester pregnant; group II, non-pregnant). Each group included three equal sub-groups; subgroup A received intra-cervical 15-Me PGF2 alpha gel, B received intracervical PGE2 gel and C received intra-cervical gel alone as placebo. Three different staining techniques were employed to study the histological picture and histochemical alterations of cervical biopsies. These showed that PG-treated cervices presented significant changes compared to placebo in terms of more widely dissociated connective tissue bundles that are separated by clear spaces and an increase in the amount of ground substance. Moreover, the observed changes in pregnant sub-groups were more evident than in the corresponding non-pregnant cases.     

The thermogenic activity of exogenous E and F prostaglandins in humans

A basic understanding of the physiologic effects of the prostaglandins on the human reproductive system has been one of the diverse scientific interests of Professor Axel Ingelman-Sundberg (19). Although the obvious clinical ultility of these ubiqitous compounds directed early attention to their therapeutic aspects, more recently there has been renewed interest in the basic physiologic mechanisms of the prostaglandins in reproductive medicine. Undoubtedly, the work of Dr Ingelman-Sundberg has stimulated many of his colleagues, students, and fellow scientists to pursue such basic studies in greater details.     

Effect of the naturally occurring prostaglandins E2 and F2 alpha on the human myometrium in vivo during pregnancy

Hysterometry has been used to evaluate the effect on the human myometrium in vivo during early pregnancy of the naturally occurring prostaglandins E2 and F2 alpha. The hystermetric technique is based upon the fact that mechanical distension of smooth muscle induces contraction. According to the analysis of the contractile responses, the effects of the agents have been determined quantitatively. The drug effects have been characterized by changes in myometrial response between registrations under basic conditions and during the infusion of the active agent, respectively. It was found that when these drugs were given in the doses usually employed in clinical practice, the effect on contractility of the PGF2 alpha compound was more pronounced than that of the PGE2. However, when describing the results on a microgram basis, the PGE2 was confirmed to be more potent than the PGF2 alpha by a factor of up to 7-8.     

The effect of prostaglandins F1 alpha and F2 alpha on spermatogenesis.

The effect of the prostaglandins F1 alpha and F2 alpha on spermatogenesis in the mature male mouse has been studied. Administration of prostaglandins F1 alpha and F2 alpha subcutaneously at a dose of 3 mg/kg once a day for 15 days produced a pronounced decrease in spermatogenesis primarily during the meiotic phase as reflected by a significant decrease in stage 7 spermatids as compared to controls. PGF2 alpha produced a stronger suppression than did PGF1 alpha. Accessory reproductive gland weights also appeared to be reduced by the prostaglandins, although not consistently. Histopathological examination revealed increased numbers of exfoliated immature germinal cells in the seminiferous tubules and epididymi of prostaglandin treated animals. When the effect of PGF1 alpha and PGF2 alpha were compared to those of PGE1 and PGE2 it was found that PGE2 produced the strongest suppression, with PGF2 alpha, PGE1 and PGF1 following in decreasing order respectively.     

Prostaglandins PGF2 alpha,E1, and F2 alpha and delivery induction by intravenous infusion

This study compares results of induced delivery by intravenous infusion of PGF2alpha, PGE1, and PGF1alpha. 100 women of average age 30.8 and average parity 2.9 underwent intravenous infusion of a dilution of 5 mcg of PGF2alpha in 1 ml of glucose water; infusion started with 2.5 mcg/minute, to reach a maximum of 25 mcg/minute. Delivery was complete in 87 cases, with an average time of 5 hours and 56 minutes; all babies were born healthy. Side effects were hyperdynamia, nausea, vomiting, and diarrhea. PGE1 was administered by intravenous infusion in 25 patients of average age 30.8 and average parity 3.2; dilution was 0.5 mcg/ml of glucose water. Average dose administered was 0.67 mcg and average infusion time was 5 hours, 23 minutes. There were 24 complete deliveries and all babies were born healthy. Side effects were vomiting and hyperdynamia. One 26 year old patient was administered PGF1alpha intravenously in a dilution of 10 mcg/1 ml of physiologic serum. Infusion started with 10 mcg/minute and increased 10 mcg every 15 minutes till a maximum of 60 mcg/minute was reached. Delivery was after 2 hours and 10 minutes; the baby was healthy and there were no side effects. Results showed that PGF1alpha is about 10 times less powerful than PGE1 from a quantitative point of view, and that side effects are similar. The article concludes with a very extensive review of the published literature on the action of PGs in delivery and abortion induction, and on the several ways of administration.     

Changes in the concentrations of prostaglandins E and F in the utero-placental tissues of late pregnant rabbit after the administration of oxytocin or prostaglandin F2 alpha

We have investigated the effects of exogenous oxytocin and prostaglandin F2 alpha (PGF2 alpha) on the concentrations of prostaglandins E and F (PGE and PGF) in the utero-placental tissues in late pregnant rabbit. The subjects were 5 rabbits each on days 26, 27 and 30 of pregnancy. After one side of the uterine horn was excised as the control, 3,000 micrograms of PGF2 alpha, 10 microU of oxytocin or 1 ml of saline was administered to 2,2 and 1 rabbits as an iv bolus dose. After 10 minutes, the remaining side of the uterine horn was excised. The myometrium, fetal and maternal cotyledon, decidua and amnion were separated. The concentrations of PGE and PGE in each tissue were measured by radioimmunoassay after extraction. The highest concentration of PGE was observed in the fetal cotyledon and that of PGF in the decidua. The amniotic PGE concentration significantly decreased after the administration of both oxytocin and PGF2 alpha. The myometrial PGF concentration increased significantly after the administration of PGF2 alpha, and the degree of the increase in PGF became greater as pregnancy advanced. However, the myometrial PGF concentration did not increase after the administration of oxytocin.     

F2 alpha prostaglandins and oxytocin in multipara: a comparative study

Differences existing between F2 alpha prostaglandin and oxytocin, as labor inductors, are studied on 2 groups of multipara by means of intravenous administration. The percent of success was somewhat higher with oxytocin. Labor's duration was prolonged with the use of prostaglandin. The interval between the start of drug's administration and the first contractions onset was shorter in cases in which oxytocin was used. No side effects were observed. (Author's modified)     

Induction of abortion by prostaglandins E (PGE1 and PGE2)

The oxytocic effects of (PGE) prostaglandins E group (PGE1, PGE2) are far more striking than those of the Falpha series (PGF1alpha, PGF2alpha) on the human pregnant uterus. Intravenous infusions of PGE1 and PGE2 for the therapeutic termination of pregnancy was studied in 30 patients. Induction of abortion was successful in 28 instances and in 23 the abortion was complete. There were no undesirable side effects.