Mechanism of action

Prescribing information

Patient information

Dismeno in the world

:: Endometriosis ::
Statistics and Facts

Endometriosis affects an estimated 176 million women worldwide regardless of their ethnic and social background. Many remain undiagnosed and are therefore not treated.1

What is Endometriosis?

Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction. This estrogen-dependent disease is predominantly found in women of reproductive age, and generally becomes inactive with menopause, unless a woman uses post-menopausal hormone therapy. The associated symptoms can impact on general physical, mental and social well-being.2,3
Endometriosis is found to be one of the conditions that cause secondary dysmenorrhea.3 Dysmenorrhea is the medical term for pain with menstruation. Secondary dysmenorrhea is caused by a disorder in the reproductive system.

What are the symptoms of Endometriosis?

The most common symptom of endometriosis is pain in the lower abdomen or pelvis, or the lower back, mainly during menstrual periods. The amount of pain a woman feels does not depend on how much endometriosis she has. Some women have no pain, even though their disease affects large areas. Other women with endometriosis have severe pain even though they have only a few small growths.4

Symptoms of endometriosis can include:
•    Very painful menstrual cramps; pain may get worse over time
•    Chronic pain in the lower back and pelvis
•    Pain during or after sex
•    Intestinal pain
•    Painful bowel movements or painful urination during menstrual periods
•    Spotting or bleeding between menstrual periods
•    Infertility or not being able to get pregnant
•    Fatigue
•    Diarrhea, constipation, bloating, or nausea, especially during menstrual periods

There may be no symptoms. Some women with a large number of tissue implants in their pelvis have no pain at all, while some women with milder disease have severe pain.4,5

How to detect Endometriosis?

To detect endometriosis, the health care provider will perform a physical exam, including a pelvic exam. Tests that are done to help diagnose endometriosis include:
•    Pelvic exam
•    Transvaginal ultrasound
•    Pelvic laparoscopy

Laparoscopy is often recommended for diagnosis and treatment if the pelvic pain persists, even after taking birth control pills and pain medicine.4,5

What are the risks and complications of Endometriosis?

Endometriosis can lead to infertility, especially those with mild endometriosis.
Other complications of endometriosis include5:
•    Long-term (chronic) pelvic pain that interferes with social and work activities
•    Large cysts in the pelvis (called endometriomas) that may break open (rupture)
•    In a few cases, endometriosis implants may cause blockages of the gastrointestinal or urinary tracts.
•    Very rarely, cancer may develop in the areas of endometriosis after menopause.

How to prevent Endometriosis?               

There are no definite ways to lower the chances of getting endometriosis. Otherwise, lower the level of estrogen in the body might help to prevent endometriosis, since estrogen is involved in thickening the lining of the uterus during the menstrual cycle.4
Some ways to keep lower estrogen levels can include 4:
•    Regular exercise
•    Keeping a low amount of body fat
•    Avoiding large amounts of alcohol and drinks with caffeine
Birth control pills may also help to prevent or slow down the development of the endometriosis.5

How to treat Endometriosis?                   

Treatments for endometriosis pain may include pain medications, hormone therapy, and surgical treatment.
Pain medications may work well to reduce mild pain. Non-steroidal anti-inflammatories (NSAIDs) are usually the preferred painkiller used to treat endometriosis. Since NSAIDs act against the inflammation caused by endometriosis, thus they help to ease pain and discomfort. Opioid is a stronger painkiller if other painkillers are not suitable. Evidence on the effectiveness of these medications for relieving endometriosis-associated pain is limited.6


Doctors will recommend hormone medicines to treat endometriosis, when pain medications are not enough to counter the pain. Only women who do not wish to become pregnant can use these drugs. Hormone treatment is best for women with small growths who do not have bad pain. Common hormones used for endometriosis include 4,5:
•    Birth control pills
•    GnRH agonists and antagonists
•    Progestins
•    Danazol


Surgery may be recommended if you have severe pain that does not get better with other treatments. Surgery may include 4,5:

  • Pelvic laparoscopy, to remove growths and scar tissue or burn them away.
  • Laparotomy or major abdominal surgery, to reach and remove growths of endometriosis in the pelvis or abdomen.
  • Hysterectomy, to remove the womb (uterus) if you have severe symptoms and do not want to have children in the future. One or both ovaries and fallopian tubes may also be removed. If you do not have both of ovaries removed at the time of hysterectomy, your symptoms may return.



Dismeno containing DLBS1442 which has been developed from Phaleria macrocarpa, works by regulating estrogen and progesterone receptors, downregulating anti-inflammatory genes and inhibiting proliferation of endometriotic tissue, that effectively helpsto treat endometriosis.7 In addition, Dismeno also reduces the pain caused by endometriosis (dysmenorrhea).


  1. Endometriosis.org. About endometriosis.  http://endometriosis.org/endometriosis/
  2. Pamela Stratton, and Karen J. Berkley. Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications. Hum Reprod Update. 2011 May-Jun; 17(3): 327–346.
  3. Kennedy S, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Human Reprod 2005;20(10):2698-2704.
  4. Office on Women's Health, U.S. Department of Health and Human Services. Endometriosis fact sheet.  http://www.womenshealth.gov/publications/our-publications/fact-sheet/endometriosis.cfm
  5. A.D.A.M. Medical Encyclopedia. Endometriosis. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001913/
  6. National Health Service Choices. Endometriosis - Treatment. http://www.nhs.uk/Conditions/Endometriosis/Pages/Treatment.aspx
  7. R. R. Tjandrawinata, P. Arifin, A. Clarissa. 2011. New concept in the treatment of premenstrual syndrome using bioactive fraction DLBS1442. Medicinus 24(3):21-24


:: Mechanism of action ::

DLBS1442 is a Bioactive Fraction extracted from Indonesian native herbal, Phaleria macrocarpa. The molecular mechanism of DLBS1442 on hormone receptors was investigated. Effect of DLBS1442 was studied using RL 95-2, endometrial carcinoma cell lines from which the total RNA was isolated to observe the response of estrogen and progesterone receptor genes. DLBS1442 was found to possess the capability in downregulating estrogen receptor gene expressions and on the other hand, upregulating progesterone receptor gene expressions in a dose-dependent manner.

Furthermore, DLBS1442 is preclinically proved to have anti-inflammatory, apoptosis induce, and antiangiogenic effects. DLBS1442 exerts its anti-inflammatory effect through selective inhibition of COX-2, an inducible prostaglandin synthase and also cPLA2. Thus, by inhibiting cPLA2 and COX-2 in synthesizing prostaglandin, as well as inhibiting proliferation of endometriotic tissue, DLBS1442 can reduce menstrual pain.

DLBS1442 is also studied clinically for its efficacy and safety in alleviating symptoms of primary dysmenorrhea. DLBS1442 was safe and well tolerated in women with premenstrual syndrome and/or dysmenorrhea.


:: Prescribing information ::


Each capsule contains:

Bioactive Fraction DLBS1442 Phaleria macrocarpa 100 mg.


Helps to relieve menstrual pain.

Warning and precautions

Only use on doctor’s recommendation. During treatment, consult your doctor regularly.

Adverse reaction

No side effects have been reported. Considered safe if taken in the recommended dosage.

Presentation and registration

Box, 5 strips @ 6 capsules, POM HT. 152.300.481


:: Patient information ::

What is Dismeno?

Dismeno is a prescribed therapy for dysmenorrhea patients including those who suffer from endometriosis. Dismeno prevents endometriosis development by conferring its pharmacological  actions including downregulating estrogen receptor and upregulating progesteron receptor, downregulating cPLA2, COX2, and PGE2 expression, as well as inhibiting proliferation on endometriotic tissue.

Contraindications to take Dismeno

You should not take Dismeno if you have hypersensitivity to one or more of its components.

How should I take Dismeno?

Dismeno should be taken three times daily, but can be customized following your doctor’s instructions. You may take Dismeno with or without food. Take the capsule with a glass of water.

What happens if I miss a dose?

If you miss taking a dose of Dismeno, take it as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What should I do while taking Dismeno?

Try to have a regular exercise, keep a low amount of body fat, and avoid consumption of alcohol and drinks with caffeine.

Dismeno side effect

No side effects have been recorded during the toxicological and clinical studies. Dismeno is considered safe if taken at the recommended dosage.

If you experience any side effect that might be caused by Dismeno, call your doctor as soon as possible.

Interaction of Dismeno with other drugs           

Dismeno does not interact with other medication.

What should I tell my doctor/pharmacist?

  • Always tell your doctor / pharmacist if you are taking any other medicine or food supplements.
  • Always tell your doctor / pharmacist if you have any allergy.
  • Women should tell their doctor / pharmacist if they are pregnant or planning to get pregnant

What storage conditions are needed for Dismeno?          

Dismeno must be stored at a temperature below 30°C.
It must be kept from light and out of reach of children.


:: Dismeno in the world ::
Dismeno is marketed in Indonesia and currently under review in other countries. Our goal is to offer the possibility for patients globally to have access to Dismeno. If you are interested in partnering with us, please see the partnership page in this website or contact us directly.