Concentrations of various arachidonic acid metabolites in menstrual fluid are associated with menstrual pain and are influenced by hormonal contraceptives

In a pilot study we investigated the association between concentrations of various eicosanoids in menstrual blood with pain and oval contraceptive use. Menstrual fluid teas collected on tampons by 12 women who did not use an oral contraceptive but suffered from slight primary dysmenorrhea and by three pain-free women who used an oval contraceptive. Eicosanoids (cyclooxygenase products: 6-ketoprostaglandin F-1 alpha, thromboxane B-2, prostaglandin E(2), prostaglandin F-2 alpha, 13,14-dihydro-15-ketoprostaglandin F-2 alpha, 12-hydroxy-heptadecatrienoic acid; lipoxygenase products: 5-, 12-, 15-hydroxy-eicosatetraenoic acid (HETE), leukotriene B-4, leukotriene C-4, leukotriene D-4, leukotriene E(4)) and female sex steroids (17 beta-estradiol and progesterone) were analyzed by the combined use of high-performance liquid chromatography and radioimmunoassay. 12-HETE was the main arachidonic acid metabolite. An increased metabolism of arachidonic acid teas associated with pain, especially when synthesis of 12-HETE was elevated. Oral contraceptive use decreased the synthesis of prostaglandins as well as leukotrienes. The concordant changes of cycloohygenase and lipoxygenase products in dysmenorrhea or in oral contraceptive use may be explained by an increased or decreased phospholipid metabolism, respectively.