Rationale of Estrogenic Therapy in Functional Dysmenorrhea1

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Abstract
Three hormonal estrogens, estradiol, estrone, and estriol and a non-hormonal estrogen, diethylstilbestrol, were employed in the treatment of functional dysmenorrhea of 18 ?? whose ages ranged from 16-30 yrs. The total dosages per cycle of therapy ranged as follows: estradiol benzoate, 6 mg.; estradiol dipropionate, 15 mg.; estrone, 0.67 to 4.67 mg.; estriol glucuronide, 7000 to 48,600 oral units; diethylstilbestrol, 10.0 mg. A total of 189 cycles was studied; 68 prior to therapy, 59 during treatment, and 62 after cessation of therapy. Estrogenic therapy was effective when administered in adequate amts. during the first half or during both halves of cycles. During therapy there was complete absence of pain in 25% and marked relief in 60% of the cycles studied. After cessation of therapy, there was complete absence of pain in 5% and marked relief in 28%. No causal relationship was found between the absence or presence of dysmenorrhea and the type of endometrium from which bleeding occurred. The concept that dysmenorrhea arises as a vascular pain and the mechanisms of pain production and relief are discussed.