PMS: Could suppressing my cycle improve my PMS?

Wyatt KM,Dimmock PW,Ismail KM,Jones PW,O'Brien PM.

Exeter and North Devon RDSU, Exeter, UK.

Objectives:

To determine the effectiveness of gonadotrophin-releasing hormone analogues (GnRHa) with and without hormonal add-back therapy in the management of premenstrual syndrome.

Design:

Randomised controlled trials were identified by searching multiple databases.

Setting:

Exeter and North Devon Research and Development Support Unit and Keele University Academic Unit of Obstetrics and Gynaecology.

Population:

Women with pre-diagnosed premenstrual syndrome and/or premenstrual dysphoric disorder.

Methods:

A meta-analysis of published randomised placebo-controlled trials assessing the use of GnRHa in the management of premenstrual syndrome. The standardised mean difference for each individual study and subsequently an overall standardised mean difference were calculated after demonstrating the consistency or homogeneity of the study results.

Settings, Design and Main Outcome Measures:

Overall improvement in premenstrual symptomatology and effectiveness of GnRHa with additional hormonal add-back therapy were the main outcome measures assessed in this analysis. A secondary analysis was performed to assess the effectiveness of GnRHa in treating physical and emotional symptoms.

Results:

Overall standardised mean difference for all trials that assessed the efficacy of GnRHa was -1.19 (95% confidence interval [CI] -1.88 to -0.51). The e quivalent odds ratio was 8.66 (95% CI 2.52 to 30.26) in favour of GnRHa. GnRHa were more efficacious for physical than behavioural symptoms, although the difference was not statistically significant. The addition of hormonal add-back therapy to GnRHa did not appear to reduce the efficacy of GnRHa alone; standardised mean difference 0.12 (95% CI -0.35 to 0.58).

Conclusions:

GnRHa appear to be an effective treatment in the management of premenstrual syndrome. The addition of hormonal add-back therapy to reduce side effects does not reduce efficacy.

Please click on the required question.

• Premenstrual Syndrome - PMS What is The Premenstrual Syndrome (PMS)
• 2 How prevalent is PMS?
• 3 How can we tell if I have PMS?
• 4 How can my PMS be evaluated?
• 5 How can cyclical breast pain (mastalgia) be treated?
• 6 How can my PMS be treated?
• 7 What is the place of progestogens and progesterone in the management of PMS?
• 8 Could suppressing my menstrual cycle reduce my PMS problems?
• 9  Could a diuretic help my PMS?
• 10 Is there a place for anti-depressants or anxiolytic drugs in the management of PMS?
• 11 Is there a place for removing my ovaries in the management of PMS?
• 12 What can be done about my decreased libido (sex drive)
• 12A What is the place of Viagra (sildenafil citrate) in sexual dysfunction in women?
• 13 How is PMS treatment monitored?
• 14 How long should PMS treatment be taken?
• 15 What is the chronic fatigue syndrome?
• 16 What is seasonal affective disorder (SAD)
• 17 Where can I obtain more information?
• 18 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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