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Efficacy of progesterone vaginal suppositories in alleviation of nervous symptoms in patients with premenstrual syndrome

Abstract

Purpose

To further investigate the efficacy of progesterone in the treatment of the symptoms of premenstrual syndrome (PMS).

Materials and Methods

From an initial cohort of 25 subjects diagnosed with moderate to severe PMS, 17 reproductive age females completed the 7-month, doubleblind, placebo controlled trial using 200-mg vaginal progestone suppositories. Multiple modalities for evaluating symptoms were employed, including the Spielberger self-evaluation rating, the Beck depression inventory, and the Hamilton anxiety scale. In addition, each subject was interviewed by a psychiatrist on a monthly basis; ovulation was determined monthly using a basal body temperature chart; serum hormonal assays included beta endorphin, progesterone, follicle stimulating hormone, luteinizing hormone, estradiol, and prolactin.

Results

Hormonal assays confirmed no differences between treatment and control groups. Overall scores on all test vehicles were likewise not significantly different between the two groups; however, in the subcategory of nervous symptoms, a significant improvement was found in symptoms relating to tension, mood swings, irritability, anxiety and lack of control.

Conclusions

Metabolites of progesterone (pregnanolone and allopregnanolone) may play a physiologic role as anxiolytic agents, perhaps modifying mood and anxiety; the current study confirms the utility of twice daily, 200-mg progesterone vaginal suppositories, in the alleviation of some PMS symptoms relating to anxiety and irritability. Further evaluation may be warranted to ascertain which patients in the known heterogeneous PMS population may be most likely to benefit from such treatment.

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References

  1. 1.

    Frank RT: The hormonal basis of premenstrual tension. Arch Neorol Psychiatry 1931;26:1053–1057

  2. 2.

    Horney K: Premenstrual tension.In Reminine Psychology. Kelman H (ed). New York, WW Norton, 1931, pp 99–106

  3. 3.

    Reid RL: Premenstrual syndrome. Curr Probl Obstet Gynecol Fertil 1985;8:7–9.4

  4. 4.

    Rubinow DR, Hoban MC, Grover GN, Galloway MS, Roy-Byrne P, Anderson R, Merriman GR: Changes in plasma hormones across the menstrual cycle in patients with menstrually related mood disorder and in control subjects. Am J Obstet Gynecol 1988;158:5–11

  5. 5.

    Dalton K: The Premenstrual Syndrome and Progesterone Therapy, 2nd ed. Chicago, Year Book Medical Publishers, 1984

  6. 6.

    Mortola JF, Girton L, Fischer U: Successful treatment of severe premenstrual syndrome by combined use of gonadotropin-releasing hormone agonist and estrogen/progestin. J Clin Endocrinol Metab 1991;71:252A-252F

  7. 7.

    Freeman E, Rickels K, Sondheimer SJ, Polansky M: Ineffectiveness of progesterone suppository treatment for premenstrual syndromes. J Am Med Assoc 1990;264:349–353

  8. 8.

    Dennerstein L, Spencer-Gardner C, Gotts G, Brown JB, Smith MA, Burrows GD: Progesterone and the premenstrual syndrome: a double-blind crossover trial. Br Med J 1985;290:1617–1621

  9. 9.

    Freeman WE, Purdy RH, Coutifaris C, Rickels K, Paul SM: Anxiolytic metabolites of progesterone: correlation with mood and performance measures following oral progesterone administration to healthy female volunteers. Neuroendocrinology 1993;58:478–484

  10. 10.

    Freeman EW, Weinstock L, Rickels K, Sondheimer SJ, Coutifaris C: A placebo-controlled study of effects of oral progesterone on performance and mood. Br J Clin Pharmacol 1992;33:293–298

  11. 11.

    Schmidt PJ, Purdy RH, Moore PH, Paul SM, Rubinow DR: Circulating levels of anxiolytic steroids in the luteal phase in women with premenstrual syndrome and in control subjects. J Clin Endocrinol Metab 1994;79:1256–1260

  12. 12.

    Paul SM, Purdy RH: Neuroactive steroids. FASEB J 1992;6:2311–2322

  13. 13.

    Majewska MD: Actions of steroids on neuron: role in personality, mood, stress and disease. Integr Psychiatry 1987;5:258–273

  14. 14.

    Mortola JF: Issues in the diagnosis and research of premenstrual syndrome. Clin Obstet Gynecol 1992;35:587–598

  15. 15.

    Ladisich W: Influence of progesterone on serotonin metabolism: a possible causal factor for mood changes. Psychoneuroendocrinology 1977;2:257–261

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Author information

Correspondence to Elizabeth R. Baker or Gordon C. Wolf.

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Baker, E.R., Best, R.G., Manfredi, R.L. et al. Efficacy of progesterone vaginal suppositories in alleviation of nervous symptoms in patients with premenstrual syndrome. J Assist Reprod Genet 12, 205–209 (1995). https://doi.org/10.1007/BF02211800

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Key words

  • progesterone
  • premenstrual syndrome
  • depression
  • anxiety
  • beta endorphin