The effect of hysterectomy or levonorgestrel‐releasing intrauterine system on premenstrual symptoms in women treated for menorrhagia: secondary analysis of a randomized controlled trial

Leminen, Henri; Heliövaara-Peippo, Satu; Halmesmäki, Karoliina; Teperi, Juha; Grénman, Seija; Kivelä, Aarre; Tuppurainen, Marjo; Paavonen, Jorma; Hurskainen, Ritva

doi:10.1111/j.1600-0412.2011.01340.x

Cited by 15 publications

(6 citation statements)

References 31 publications

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“…An RCT comparing hysterectomy with the LNG‐IUS 52 mg in alleviating PMS symptoms as a secondary analysis showed benefit. However, the women presented with menorrhagia and diagnosis was not prospectively confirmed using a validated tool.…”

Section: How Is Pms Managed?mentioning

confidence: 99%

Management of Premenstrual Syndrome

2016

BJOG

102

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Section: How Is Pms Managed?mentioning

confidence: 99%

Management of Premenstrual Syndrome

2016

BJOG

102

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“…In order to eliminate ovarian function, women may desire to proceed with bilateral oophorectomy. This approach has been shown to be effective in women with severe PMS [43][44][45]. If bilateral salpingo-oophorectomy is being considered as treatment modality for severe and debilitating symptoms of PMS, it may be beneficial to consider a trial of GnRHa first to establish the relative contributions of endocrine-related pathology as the etiology of symptoms versus underlying other dysfunction.…”

Section: Bilateral Oophorectomy And/or Hysterectomymentioning

confidence: 99%

Premenstrual syndrome: management and pathophysiology

Imai¹,

Ichigo²,

Matsunami³

et al. 2015

Clin. Exp. Obstet. Gynecol.

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Premenstrual syndrome (PMS) is triggered by hormonal events ensuing after ovulation. The symptoms can begin in the early, mid, or late luteal phase and are not associated with defined concentrations of any specific gonadal or non-gonadal hormone. Women with PMS experience affective or somatic symptoms that cause severe dysfunction in social or occupational realms. Although evidence for a hormonal abnormality has not been established, the symptoms of the premenopausal disorders are related to the production of progesterone by the ovary. The progesterone metabolites may bind to a neurosteroid-binding site on the membrane of the neurotransmitters. Thus, ovulation suppression is an area of focus for diagnostic and treatment options. Many treatment studies have focused on suppression of ovulation with gonadotropin-releasing hormone analogs (GnRHa), high doses of transdermal estrogen, and bilateral oophorectomy all have positive evidence as treatment options for prevention of PMS. However, because of these limitations and their substantial intensive care, these do not appear to be appropriate methods for conventional treatment of PMS. Serotonergic antidepressants, selective serotonin reuptake inhibitors, are well-established, highly effective, and first-line pharmacologic therapy.

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“…After 21 interviews no more new codes were found, and thus saturation was achieved. We provided figures to indicate whether the results had been obtained from few (1-3), some (4-8), many (9)(10)(11)(12)(13)(14)(15)(16)(17)(18), or most (19)(20)(21)(22)(23)(24)(25)(26)(27)(28) participants. COREQ criteria were applied for reporting qualitative research [20].…”

Section: Discussionmentioning

confidence: 99%

“…If desired, and to reduce hormonal changes, the GP can in shared decision-making advise on hormonal contraception. However, there is no conclusive evidence for a long-term effect on PMS complaints [27][28][29].…”

Section: Main Findingsmentioning

confidence: 99%

Views of Dutch general practitioners about premenstrual symptoms: A qualitative interview study

Labots-Vogelesang

Teunissen

Kranenburg

et al. 2021

European Journal of General Practice

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Background General practitioners (GPs) encounter women suffering from premenstrual symptoms. Often women with premenstrual problems experience little understanding from GPs. Views of GPs will influence their approach to these women and their care. Insight into these views is lacking but could help in designing educational programmes for GPs. Objectives To explore the views of Dutch GPs towards aetiology, diagnostic process, and preferred treatment of premenstrual symptoms. Methods In 2017, we conducted a qualitative, semi-structured, interview survey among 27 GPs, varying in age, gender, and practice setting. Results Important themes emerged from the interviews: ‘no need for a symptom diary,’ ‘PMS defined as illness’ exclusively in case of disruption of normal functioning, and ‘symptomatic treatment’ as preferred approach. Most GPs considered PMS to be a physiological phenomenon, with taking history as an adequate diagnostic tool. Almost all GPs regarded a normal cyclical hormonal cycle as causal; many also mentioned the combination with personal sensitivity. Some pointed to a dividing line between physiological condition and illness if women could not function normally in daily life. Lastly, the approach GPs preferred was focussing on relieving symptoms of individual patients. In addition to explaining the hormonal cycle and lifestyle advice, all GPs advocated oral contraceptives, and if necessary psychological support. GPs expressed negative feelings about prescribing antidepressants. Conclusion GPs considered physiological changes and personal sensitivity as aetiological factors. We recommend more training to improve GPs knowledge and more insight into the burden of women with PMS. A symptom diary is an essential diagnostic tool for GPs.

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The effect of hysterectomy or levonorgestrel‐releasing intrauterine system on premenstrual symptoms in women treated for menorrhagia: secondary analysis of a randomized controlled trial

Abstract: Both hysterectomy and LNG-IUS seem to alleviate premenstrual symptoms of women treated for menorrhagia, while the effect of these treatments on premenstrual syndrome remains unsettled.

Cited by 15 publications

References 31 publications

Management of Premenstrual Syndrome

Management of Premenstrual Syndrome

Premenstrual syndrome: management and pathophysiology

Views of Dutch general practitioners about premenstrual symptoms: A qualitative interview study

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