Dopaminergic Drug Very Effective for Relieving Pelvic Pain in Women Even When Hormonal Therapy and Surgery Were not Sufficient

There have been multiple case reports demonstrating marked relief of various pelvic disorders following treatment with dopaminergic drugs especially dextroamphetamine sulfate. The theoretical reason for treating pelvic pain, including women with documented endometriosis and adenomyosis, was based on experimental evidence that dopamine functions to diminish cellular permeability; and that increased cellular permeability of pelvic tissues, whether genetic or acquired from infection or trauma, allows the infusion of excessive irritants leading to inflammation and pain. Most of these anecdotal reports have come from mainly one reproductive endocrinology clinic. The present study reported here was to either corroborate or refute the concept that dopaminergic drugs are very effective to relieve pain even when standard therapy has failed, by a completely different gynecology center. More than half of the patients had prior laparoscopic treatment of endometriosis, and all had various standard medical therapies that failed. 17 of 25 (68.0%) reported marked relief of pain and 2 others reported moderate relief (76% marked or moderate relief after 3 months of therapy). Experience suggests that most of the remaining 25% would gain relief by increasing the dosage. The advantage of dopaminergic therapy besides being more effective for pain relief than standard medical therapy or surgery is that not only can the patient try to conceive while on it, but evidence suggests it will improve fertility by inhibiting immune rejection. Dopamine antagonists may also prevent a decrease in egg reserve by interfering with inflammatory damage.