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使用胰高血糖素样肽-1激动剂治疗难治性痛经:一例报告

Refractory Dysmenorrhea Managed With a Glucagon-Like Peptide-1 Agonist: A Case Report.

作者信息

Tran Mary, Swartz Nicholas, Elisèe Sabine D

机构信息

Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.

Family Medicine, Cornerstone Medical Group, Coral Springs, USA.

出版信息

Cureus. 2025 Jan 13;17(1):e77387. doi: 10.7759/cureus.77387. eCollection 2025 Jan.

Abstract

Dysmenorrhea includes symptoms such as abdominal pain, nausea, and vomiting. It is a clinical diagnosis with typical treatment involving the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapy. Even with conventional treatment, many women deal with dysmenorrhea refractory to treatment. They are often subject to dealing with the adverse effects of those treatments, such as peptic ulcer disease. We present a case of a patient with severe refractory dysmenorrhea who was able to minimize symptoms with the use of semaglutide, a glucagon-like peptide-1 (GLP-1) agonist. With no changes in the patient's lifestyle and no additional medications added, the semaglutide therapy was able to minimize the patient's symptoms to where she was able to continue activities of daily living and minimize the use of NSAID therapy. Moreover, the patient experienced no changes in weight and only transient loss of appetite while on semaglutide. We hypothesize that anti-estrogenic and anti-inflammatory properties are potential mechanisms of action in this case. This case brings to light the possible multifaceted applications of GLP-1 agonists beyond weight control and diabetes. The outcome of this case suggests that a controlled trial of GLP-1 agonist therapy is warranted to determine its potential for the management of dysmenorrhea.

摘要

痛经包括腹痛、恶心和呕吐等症状。它是一种临床诊断,典型的治疗方法包括使用非甾体抗炎药(NSAIDs)和激素疗法。即使采用传统治疗,许多女性的痛经仍难以治愈。她们常常要应对这些治疗的副作用,如消化性溃疡病。我们报告一例严重难治性痛经患者,使用胰高血糖素样肽-1(GLP-1)激动剂司美格鲁肽后症状得以减轻。在患者生活方式未改变且未添加其他药物的情况下,司美格鲁肽治疗能够将患者的症状减轻到她能够继续日常生活活动并减少NSAID治疗的使用。此外,患者在使用司美格鲁肽期间体重没有变化,仅出现短暂食欲减退。我们推测抗雌激素和抗炎特性可能是该病例中的作用机制。该病例揭示了GLP-1激动剂在体重控制和糖尿病之外可能存在的多方面应用。该病例的结果表明,有必要进行GLP-1激动剂治疗的对照试验,以确定其在治疗痛经方面的潜力。

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3
Glucagon-like peptide agonists: A prospective review.胰高血糖素样肽激动剂:前瞻性综述。
Endocrinol Diabetes Metab. 2024 Jan;7(1):e462. doi: 10.1002/edm2.462. Epub 2023 Dec 14.
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Tirzepatide Once Weekly for the Treatment of Obesity.司美格鲁肽每周一次治疗肥胖症。
N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4.
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Once-Weekly Semaglutide in Adults with Overweight or Obesity.每周一次司美格鲁肽在超重或肥胖成人中的应用。
N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10.
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Primary Dysmenorrhea: Diagnosis and Therapy.原发性痛经:诊断与治疗。
Obstet Gynecol. 2020 Nov;136(5):1047-1058. doi: 10.1097/AOG.0000000000004096.
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Inflammatory Markers in Dysmenorrhea and Therapeutic Options.痛经的炎症标志物及治疗选择。
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