🩸 Dysmenorrhea Prostaglandin Mechanism Simulator

Endometrial Breakdown Triggers the Dysmenorrhea Cascade

Falling progesterone destabilizes the endometrium at menses onset.

• Menses: Cycle phase (Day 1 onset)
• Progesterone drop: Trigger (Late luteal phase)
• Lysosome release: Tissue event (Membrane breakdown)
• ~50–90%: Affected women (Report dysmenorrhea)

Why shedding starts the pain pathway

Placeholder: falling hormones destabilize endometrial cell membranes, freeing arachidonic acid.

Arachidonic Acid to Prostaglandin via COX Enzymes

COX-1 and COX-2 convert arachidonic acid into PGF2α and PGE2.

• COX-1/COX-2: Key enzyme (Cyclooxygenase)
• PGF2α: Main mediator (Vasoconstrictor)
• Arachidonic acid: Precursor (Membrane phospholipid)
• Day 1–2: Peak levels (Of menstruation)

Synthesis pathway placeholder

Placeholder: phospholipase A2 frees arachidonic acid, COX oxidizes it into prostaglandin precursors.

Prostaglandins Drive Hypercontractile Uterine Spasm

High PGF2α causes sustained myometrial contraction and ischemia.

• >150 mmHg: Pressure rise (Vs. ~80 normal)
• >4–5/10min: Contraction freq (Hypercontractility)
• Uterine ischemia: Result (Reduced blood flow)
• Cramping pain: Symptom (Pelvic/lower back)

Spasm mechanism placeholder

Placeholder: prostaglandins bind myometrial receptors, driving vasoconstriction and painful contractions.

NSAIDs Inhibit COX to Cut Prostaglandin Output

NSAIDs block the COX active site, reducing new prostaglandin synthesis.

• NSAIDs: Drug class (Ibuprofen, naproxen)
• COX active site: Target (Competitive inhibition)
• ↓PG synthesis: Effect (Not existing PG)
• ~30–60 min: Onset (Oral absorption)

Blockade mechanism placeholder

Placeholder: NSAIDs occupy the COX enzyme pocket, preventing further arachidonic acid conversion.

Why Early Dosing Improves Pain Relief Outcomes

Dosing before pain onset blocks synthesis before prostaglandins accumulate.

• Pre-onset: Best timing (1–2 days before)
• Lower relief: Late dosing (PG already high)
• ~70–90%: Relief rate (With early NSAID use)
• Scheduled dosing: Strategy (Not as-needed only)

Timing dependence placeholder

Placeholder: earlier NSAID timing prevents the prostaglandin surge rather than reversing it.

Placeholder: start NSAIDs before pain begins for the strongest relief effect.