Dysmenorrhea is a common disease that is known to be experienced by 50% of menstruating women. Most dysmenorrhea patients complain of primary dysmenorrhea, which interferes with daily life. Dangguijakyaksan (DJS) is one of the oriental medicines prescribed for the treatment of dysmenorrhea. However, these oriental medicine prescriptions are not trusted by many people due to the lack of objective evidence for them. In this regard, we tried to confirm the effect of DJS by investigating endogenous metabolite changes before and after DJS administration to subjects with mild dysmenorrhea.

In this study, we investigated plasma metabolites in volunteers (n=17) with mild dysmenorrhea immediately before administration and in the second menstrual cycle after administration. Non-targeted metabolic profiling was performed using ultra high performance liquid chromatography and quadrupole time-of-flight/mass spectroscopy. After data preprocessing, multivariate statistical analysis was performed. Then metabolites were identified through MetaboScape (Bruker Daltonics, Germany) software and web databases.

Through multivariate statistical analysis, we obtained valid orthogonal projections latent structural discriminant analysis (OPLS-DA) comparing before and after administration. In this model, phosphatidylcholine and lysophosphatidylcholine were decreased after administration. These phospholipids from the cell membrane are known to be involved in the early stages of the inflammatory cascades, and are thought to be involved in the pathogenesis of dysmenorrhea. In addition, using the degree of change in the visual analogue scale value indicating the level of pain, responder group (n=9) and non-responder group (n=8) were divided and OPLS-DA was performed for each group. In further study, we expect to identify metabolites and related pathways that show differences between responders and non-responders.