CNS Drugs

, Volume 17, Issue 5, pp 325–342

The Role of Hormones and Hormonal Treatments in Premenstrual Syndrome

Authors

    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Lotta Andreen
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Vita Birzniece
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Inger Björn
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Inga-Maj Johansson
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Maud Nordenstam-Haghjo
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Sigrid Nyberg
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Inger Sundström-Poromaa
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Göran Wahlström
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Mingde Wang
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
  • Di Zhu
    • Department of Clinical Sciences, Obstetrics and GynecologyUmeå University
Review Article

DOI: 10.2165/00023210-200317050-00003

Cite this article as:
Bäckström, T., Andreen, L., Birzniece, V. et al. CNS Drugs (2003) 17: 325. doi:10.2165/00023210-200317050-00003
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Abstract

Premenstrual syndrome (PMS) is a menstrual cycle-linked condition with both mental and physical symptoms. Most women of fertile age experience cyclical changes but consider them normal and not requiring treatment. Up to 30% of women feel a need for treatment. The aetiology is still unclear, but sex steroids produced by the corpus luteum of the ovary are thought to be symptom provoking, as the cyclicity disappears in anovulatory cycles when a corpus luteum is not formed. Progestogens and progesterone together with estrogen are able to induce similar symptoms as seen in PMS. Symptom severity is sensitive to the dosage of estrogen. The response systems within the brain known to be involved in PMS symptoms are the serotonin and GABA systems. Progesterone metabolites, especially allopregnanolone, are neuroactive, acting via the GABA system in the brain. Allopregnanolone has similar effects as benzodiazepines, barbiturates and alcohol; all these substances are known to induce adverse mood effects at low osages in humans and animals. SSRIs and substances inhibiting ovulation, such as gonadotrophin-releasing hormone (GnRH) agonists, have proven to be effective treatments. To avoid adverse effects when high dosages of GnRH agonists are sed, add-back hormone replacement therapy is recommended. Spironolactone also has a beneficial effect, although not as much as SSRIs and GnRH agonists

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© Adis Data Information BV 2003