Management Strategies for Premenstrual Syndrome/Premenstrual Dysphoric Disorder

Jarvis, Courtney I.; Lynch, Ann M.; Morin, Anna K.

doi:10.1345/aph.1k673

Cited by 61 publications

(36 citation statements)

References 71 publications

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“…[8–1013–15] The treatment therefore will depend on the particular symptom complex in the individual woman. [1617] In concordance with other authors, we have also observed PMTS in cases with subclinical hypothyroidism. [18] Thyroid replacement therapy is usually simple to follow.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of premenstrual symptoms: Preliminary analysis and brief review of management strategies

Joshi¹,

Pandey²,

Galvankar³

et al. 2010

J Mid-life Health

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Objective:To determine the prevalence of premenstrual cyclic symptoms in perimenopausal age.Subjects and Methods:Women attending Bhavan's SPARC Maitreyi's Health Care Programme (HCP) for women around 40 years of age were included in the study. Last 200 women who attended from April 2002 to October 2004 are included for analysis. Out of these 107 qualified for final analysis as others were post hysterectomy or post menopausal. Thirty five symptoms listed under premenstrual tension syndrome were analysed.Results:Forty one women (38.3%) had 3 or more symptoms whilst 15 (14.0%) had 5 or more cyclic symptoms. Five women (4.7%) reported that the symptoms were severe. Eleven women had seeked treatment for premenstrual tension syndrome (PMTS). The commonest symptom was mastalgia or heaviness of breasts. Next was whilst also was reported by several women. Women reported anger attacks and reported depression.Conclusion:PMTS was common between 36 and 55 years. About half of them have experienced 3 more symptoms and 1 in 20 may require treatment.

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Section: Discussionsupporting

confidence: 92%

Prevalence of premenstrual symptoms: Preliminary analysis and brief review of management strategies

Joshi¹,

Pandey²,

Galvankar³

et al. 2010

J Mid-life Health

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“…These medications have no overlap in labeled indications; however, drospirenone does have an indication for acne vulgaris, while spironolactone has an off-label use for its treatment. Another likely explanation in the recent literature is that drospirenone and spironolactone are both seen as beneficial for treatment of weight gain and bloating experienced by patients with postmenstrual dysphoric disorder and in reducing hirsutism and acne in patients with polycystic ovarian syndrome (PCOS) [24-28]. …”

Section: Discussionmentioning

confidence: 99%

The association between drospirenone and hyperkalemia: a comparative-safety study

et al. 2011

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BackgroundDrospirenone/ethinyl-estradiol is an oral contraceptive (OC) that possesses unique antimineralocorticoid activity. It is conjectured that drospirenone, taken alone or concomitantly with spironolactone, may be associated with an increased risk of hyperkalemia.MethodsA retrospective cohort study was conducted evaluating women between 18-46 years of age in the Lifelink™ Health Plan Claims Database. The study was restricted to new users of OCs between 1997-2009. Cox proportional hazards models were used to estimate the time to first occurrence of hyperkalemia diagnosis. The main analysis compared OCs containing drospirenone with OCs containing levonorgestrel, a second generation OC not known to impact potassium homeostasis. Logistic regression evaluated concomitant prescribing of drospirenone and spironolactoneResultsThe cohort included 1,148,183 women, averaging 28.8 years of age and 280 days of OC therapy. 2325 cases of hyperkalemia were identified. The adjusted hazard ratio (HR) for hyperkalemia with drospirenone compared to levonorgestrel was 1.10 (95%CI 0.95-1.26). There was an increased risk of hyperkalemia with norethindrone HR 1.15 (95%CI: 1.00-1.33) and norgestimate HR 1.27 (95%CI: 1.11-1.46). Other OCs were unassociated with hyperkalemia. The odds of receiving spironolactone while taking drospirenone were 2.66 (95%CI 2.53-2.80) times higher than the odds of receiving spironolactone and levonorgestrel. Only 6.5% of patients taking drospirenone and spironolactone had a serum potassium assay within 180 days of starting concomitant therapy.ConclusionsA clinically significant signal for hyperkalemia with drospirenone was not demonstrated in the current study. Despite the bolded warning for hyperkalemia with joint drospirenone and spironolactone administration, physicians are actually using them together preferentially, and are not following the recommended potassium monitoring requirements in the package insert.

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“…10,11 Despite the high prevalence of PMS, few risk factors have been consistently identified, [12][13][14] little is known about the etiology of symptoms, and no universal treatment exists. A suspected etiological pathway is linked to slight irregularities in the normal variation of ovarian hormones throughout the menstrual cycle, as ovulation suppression is known to avert premenstrual symptoms; 15 however, differences in reproductive hormone levels have not been consistently identified. [16][17][18][19] Although not entirely clear, psychosocial stress may impact the severity of perimenstrual symptoms (premenstrual= menstrual weeks) through activation of the hypothalamicpituitary-ovarian (HPO) axis, thus altering ovarian hormone levels, or stimulation of the sympathetic nervous system, leading to altered levels of neurotransmitters and other brain processes.…”

mentioning

confidence: 99%

Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study

Gollenberg

Hediger

Mumford

et al. 2010

Journal of Women's Health

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Objective: To examine the longitudinal relation between perceived stress in the previous month and perimenstrual symptom severity across two cycles among regularly menstruating, healthy women (n ¼ 259). Methods: At baseline (11 days before the first cycle), participants completed the 4-item Perceived Stress Scale (PSS) for the previous month (first cycle exposure) and questionnaires on lifestyle factors. On cycle day 22 of a standardized 28-day cycle, participants again completed the PSS for the previous week (second cycle exposure) and each week rated the severity (none, mild, moderate, severe) of 17 psychological and physical symptoms (e.g., crying, cramping, pain). Mixed models estimated the association between perceived stress scores and number of moderate=severe symptoms and symptom severity scores, allowing both stress and perimenstrual symptoms to vary by cycle. Results: Adjusting for age, education, passive and active smoking, and waist=height ratio (WHtR), high stress (fourth quartile PSS) was associated with an increased risk of reporting !8 or more (OR 7.2,) and !5 (OR 2.5, 1.6-4.1) symptoms as moderate=severe during the perimenstrual period compared with lower stress (quartiles one, two, and three). Stress scores were positively ( p < 0.0001) associated with increased symptom severity scores for total, psychological, and physical symptoms. Conclusions: These analyses show that higher perceived stress precedes an increased severity of perimenstrual symptoms. Stress reduction programs may be an effective, nonpharmaceutical treatment for physical and psychological symptom relief.

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Management Strategies for Premenstrual Syndrome/Premenstrual Dysphoric Disorder

Abstract: Healthcare providers need to be aware of the symptoms of PMS and PMDD and the treatment options available. Treatment selection should be based on individual patient symptoms, concomitant medical history, and need for contraception.

Cited by 61 publications

References 71 publications

Prevalence of premenstrual symptoms: Preliminary analysis and brief review of management strategies

Prevalence of premenstrual symptoms: Preliminary analysis and brief review of management strategies

The association between drospirenone and hyperkalemia: a comparative-safety study

Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study

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