Wetenschappelijk onderzoek over het premenstrueel syndroom (PMS)

Het protocol voor de behandeling het premenstrueel syndroom (PMS) is op basis van wetenschappelijke publicaties ontwikkeld. Hierbij is gebruik gemaakt van de National Library of Medicine (PubMed). Daar waar mogelijk werden studies die opgezet zijn volgens het “placebo controlled cross-over” principe gebruikt. Andere vormen die vaak werden gebruik zijn reviews en epidemiologisch onderzoek. Publicaties uit bladen als The Lancet, American Journal of Cardiology, The New England Journal of Medicine hadden de voorkeur

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Causes

National Library of Medicine (PubMed)
    REVIEW
  1. Rapkin AJ1, Akopians AL. Menopause Int. 2012 Jun;18(2):52-9. doi: 10.1258/mi.2012.012014. Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder
    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. Although evidence for a hormonal abnormality has not been established, the symptoms of the premenstrual disorders are related to the production of progesterone by the ovary.
    [Abstract]
  2. Usman SB1, Indusekhar R, O’Brien S. Best Pract Res Clin Obstet Gynaecol. 2008 Apr;22(2):251-60. Hormonal management of premenstrual syndrome
    PMS results from ovulation and appears to be caused by the progesterone produced following ovulation in women who have enhanced progesterone sensitivity. This enhanced sensitivity may be due to neurotransmitter dysfunction.[Abstract]
  3. Winer SA1, Rapkin AJ. J Reprod Med. 2006 Apr;51(4 Suppl):339-47. Premenstrual disorders: prevalence, etiology and impact
    Some women appear to have a genetic predisposition toward severe premenstrual symptoms or to have vulnerability traits that increase their risk. It has been suggested that 1 or more neurotransmitters and/or neurohormonal systems in certain women may have an abnormal response to normal fluctuations in gonadal hormones across the menstrual cycle.[Abstract]
  4. Halbreich U. Psychoneuroendocrinology. 2003 Aug;28 Suppl 3:55-99. The etiology, biology, and evolving pathology of premenstrual syndromes
    Several biologic mechanisms that underlie menstrually related symptoms have been proposed. They focus mostly on gonadal hormones, their metabolites and interactions with neurotransmitters and neurohormonal systems, such as serotonin, GABA, cholecystokinin, and the renin-angiotensin-aldosterone system. Altered responses of these systems to gonadal hormone’s fluctuations during the menstrual cycle, as well as an increased sensitivity to changes in gonadal hormones may contribute to menstrually related symptoms in vulnerable women.[Abstract]
  5. CLINICAL
  6. Clayton AH1, Keller AE, Leslie C, Evans W. Arch Womens Ment Health. 2006 Jan;9(1):51-7. Exploratory study of premenstrual symptoms and serotonin variability
    This study’s results are consistent with a hypothesis implicating serotonin in the generation of premenstrual symptomology.[Abstract]

Symptoms

  1. From Wikipedia, the free encyclopedia Premenstrual syndrome
    Premenstrual syndrome (PMS) is a collection of emotional symptoms, with or without physical symptoms, related to a woman’s menstrual cycle.[Article]
  2. From Wikipedia, the free encyclopedia Premenstrual dysphoric disorder
    Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome.[Article]
  3. Johnson SR. Obstet Gynecol. 2004 Oct;104(4):845-59. Premenstrual syndrome, premenstrual dysphoric disorder, and beyond: a clinical primer for practitioners
    The differential diagnosis of cyclic symptoms, including depression and anxiety disorders, menstrual migraine, and mastalgia.[Abstract]
  4. Leminen H1, Paavonen J. Duodecim. 2013;129(17):1756-63. PMS and PMDD
    The symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) significantly impair daily functioning. Symptoms occur in the late luteal phase. There must be a symptom-free interval between the end of menstruation and the time of ovulation..[Abstract]
  5. From Wikipedia, the free encyclopedia Premenstrual syndrome – Signs and symptoms
    More than 200 different symptoms have been associated with PMS, but the three most prominent symptoms are: irritability, tension, and dysphoria (unhappiness).[1] Common emotional and non-specific symptoms include stress, anxiety, difficulty in falling asleep (insomnia), headache, fatigue, mood swings, increased emotional sensitivity, and changes in libido.[4] Physical symptoms associated with the menstrual cycle include bloating, abdominal cramps, constipation, swelling or tenderness in the breasts, cyclic acne, and joint or muscle pain.[Article]
  6. Dickerson LM, Mazyck PJ, Hunter MH. Am Fam Physician. 2003 Apr 15;67(8):1743-52. Premenstrual syndrome
    The disorders can manifest with a wide variety of symptoms, including depression, mood lability, abdominal pain, breast tenderness, headache, and fatigue. [Abstract]

Supplements

Algemeen

    REVIEW
  1. Freeman EW. Expert Opin Pharmacother. 2010 Dec;11(17):2879-89. doi: 10.1517/14656566.2010.509344. Therapeutic management of premenstrual syndrome
    There are treatments with demonstrated efficacy for PMS, and the majority of women can be helped.[Abstract]
  2. REVIEW
  3. Rapkin AJ1, Mikacich JA. Paediatr Drugs. 2013 Jun;15(3):191-202. doi: 10.1007/s40272-013-0018-4. Premenstrual dysphoric disorder and severe premenstrual syndrome in adolescents
    Numerous epidemiologic studies have demonstrated that premenstrual disorders (PMDs) begin during the teenage years. At least 20 % of adolescents experience moderate-to-severe premenstrual symptoms associated with functional impairment. Premenstrual syndrome (PMS) consists of physical and/or psychological premenstrual symptoms that interfere with functioning. Symptoms are triggered by ovulation and resolve within the first few days of menses. The prevalence of premenstrual dysphoric disorder (PMDD), a severe form of PMS accompanied by affective symptoms, is likely equal to or higher than in adults. The diagnosis of a PMD requires a medical and psychological history and physical examination but it is the daily prospective charting of bothersome symptoms for two menstrual cycles that will clearly determine if the symptoms are related to a PMD or to another underlying medical or psychiatric diagnosis. The number and type of symptoms are less important than the timing. Randomized controlled trials of pharmacologic treatments in teens with moderate-to-severe PMS and PMDD have yet to be performed. However, clinical experience suggests that treatments that are effective for adults can be used in adolescents. PMS can be ameliorated by education about the nature of the disorder, improving calcium intake, performing exercise and reducing stress, but to treat severe PMS or PMDD pharmacologic therapy is usually required. Eliminating ovulation with certain hormonal contraceptive formulations or gonadotropin-releasing hormone agonists will be discussed. Serotonergic agonists are a first-line therapy for adults, and some serotonin reuptake inhibitors such as fluoxetine and escitalopram can be administered safely to teens.[Abstract]
  4. REVIEW
  5. Biggs WS1, Demuth RH. Am Fam Physician. 2011 Oct 15;84(8):918-24. Premenstrual syndrome and premenstrual dysphoric disorder
    Premenstrual syndrome is defined as recurrent moderate psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20 to 32 percent of premenopausal women. Women with premenstrual dysphoric disorder experience affective or somatic symptoms that cause severe dysfunction in social or occupational realms. The disorder affects 3 to 8 percent of premenopausal women. Proposed etiologies include increased sensitivity to normal cycling levels of estrogen and progesterone, increased aldosterone and plasma renin activity, and neurotransmitter abnormalities, particularly serotonin. The Daily Record of Severity of Problems is one tool with which women may self-report the presence and severity of premenstrual symptoms that correlate with the criteria for premenstrual dysphoric disorder in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision. Symptom relief is the goal for treatment of premenstrual syndrome and premenstrual dysphoric disorder. There is limited evidence to support the use of calcium, vitamin D, and vitamin B6 supplementation, and insufficient evidence to support cognitive behavior therapy. Serotonergic antidepressants (citalopram, escitalopram, fluoxetine, sertraline, venlafaxine) are first-line pharmacologic therapy..[Abstract]
  6. REVIEW
  7. Rapkin AJ1, Mikacich JA. Pediatr Endocrinol Rev. 2006 Jan;3 Suppl 1:132-7. Premenstrual syndrome in adolescents: diagnosis and treatment
    It is estimated that 60-80% of menstruating women experience some degree of premenstrual symptomatology; however the diagnosis of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) is assigned, using defined criteria, to those women whose lives are significantly affected by moderate to severe symptoms. Though these diagnoses are not frequently made in the adolescent group, the literature suggests that a similar proportion of teens would also meet criteria for PMS/PMDD. In adolescents, treatment should begin with education and lifestyle changes; however, many of the treatments used commonly in adults can also be employed safely in severe adolescent cases.[Abstract]
  8. REVIEW
  9. Dickerson LM1, Mazyck PJ, Hunter MH. Am Fam Physician. 2003 Apr 15;67(8):1743-52. Premenstrual syndrome
    Premenstrual syndrome, a common cyclic disorder of young and middle-aged women, is characterized by emotional and physical symptoms that consistently occur during the luteal phase of the menstrual cycle. Women with more severe affective symptoms are classified as having premenstrual dysphoric disorder. Although the etiology of these disorders remains uncertain, research suggests that altered regulation of neurohormones and neurotransmitters is involved. Premenstrual syndrome and premenstrual dysphoric disorder are diagnoses of exclusion; therefore, alternative explanations for symptoms must be considered before either diagnosis is made. The disorders can manifest with a wide variety of symptoms, including depression, mood lability, abdominal pain, breast tenderness, headache, and fatigue. Women with mild symptoms should be instructed about lifestyle changes, including healthy diet, sodium and caffeine restriction, exercise, and stress reduction. Supportive strategies, such as use of a symptom diary, may be helpful in diagnosing and managing the disorders. In women with moderate symptoms, treatment includes both medication and lifestyle modifications. Dietary supplements, such as calcium and evening primrose oil, may offer modest benefit. Selective serotonin reuptake inhibitors such as fluoxetine and sertraline are the most effective pharmacologic agents. Prostaglandin inhibitors and diuretics may provide some relief of symptoms. Only weak evidence supports the effectiveness of gonadotropin-releasing hormone agonists, androgenic agents, estrogen, progesterone, or other psychotropics, and side effects limit their use.[Article]

Calcium

    REVIEW
  1. Thys-Jacobs S. J Am Coll Nutr. 2000 Apr;19(2):220-7. Micronutrients and the premenstrual syndrome: the case for calcium
    This strongly suggests that PMS represents the clinical manifestation of a calcium deficiency state that is unmasked following the rise of ovarian steroid hormone concentrations during the menstrual cycle.[Article]
  2. RCT
  3. Thys-Jacobs S, Ceccarelli S, Bierman A, Weisman H, Cohen MA, Alvir J. J Gen Intern Med. 1989 May-Jun;4(3):183-9. Calcium supplementation in premenstrual syndrome: a randomized crossover trial
    Calcium supplementation is a simple and effective treatment for premenstrual syndrome, but further studies will be needed to determine its precise role in PMS.[Abstract]
  4. Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Am J Obstet Gynecol. 1998 Aug;179(2):444-52. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group
    Calcium supplementation is a simple and effective treatment in premenstrual syndrome, resulting in a major reduction in overall luteal phase symptoms.[Abstract]
  5. Ghanbari Z, Haghollahi F, Shariat M, Foroshani AR, Ashrafi M. Taiwan J Obstet Gynecol. 2009 Jun;48(2):124-9. Effects of calcium supplement therapy in women with premenstrual syndrome
    Our results showed that calcium supplements reduced early fatigability, changes in appetite, and depression in women with PMS.[Abstract]
  6. Khajehei M, Abdali K, Parsanezhad ME, Tabatabaee HR. Int J Gynaecol Obstet. 2009 May;105(2):158-61. Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrom
    Treatment with dydrogesterone or calcium plus vitamin D had a similar effect on symptom severity in women with PMS.[Abstract]
  7. Alvir JM, Thys-Jacobs S. Psychopharmacol Bull. 1991;27(2):145-8. Premenstrual and menstrual symptom clusters and response to calcium treatment
    Calcium supplementation reduced negative affect (p = .045), water retention (p = .003), and pain (p = .036) during the luteal phase and pain (p = .02) during the menstrual phase.[Abstract]
  8. REVIEW
  9. Whelan AM, Jurgens TM, Naylor H. Can J Clin Pharmacol. 2009 Fall;16(3):e407-29. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review
    Only calcium had good quality evidence to support its use in PMS. Further research is needed, using RCTs of adequate length, sufficient sample size, well-characterized products and measuring the effect on severity of individual PMS symptoms.[Abstract]
  10. Ward MW, Holimon TD. Ann Pharmacother. 1999 Dec;33(12):1356-8. Calcium treatment for premenstrual syndrome
    Calcium supplementation of 1200-1600 mg/d, unless contraindicated, should be considered a sound treatment option in women who experience premenstrual syndrome. The supplemental dose of calcium can be adjusted downward in the few patients who routinely consume large quantities of calcium in their diet.[Abstract]
  11. Bendich A. J Am Coll Nutr. 2000 Feb;19(1):3-12. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms
    However, only one supplement-calcium-has been demonstrated to be of significant benefit in a large, rigorous, double-blind, placebo-controlled trial. [Abstract]
  12. Bertone-Johnson ER, Hankinson SE, Bendich A, Johnson SR, Willett WC, Manson JE. Arch Intern Med. 2005 Jun 13;165(11):1246-52. (GlaxoSmithKline) Calcium and vitamin D intake and risk of incident premenstrual syndrome
    A high intake of calcium and vitamin D may reduce the risk of PMS. Large-scale clinical trials addressing this issue are warranted. Given that calcium and vitamin D may also reduce the risk of osteoporosis and some cancers, clinicians may consider recommending these nutrients even for younger women.[Article]
  13. OTHER
  14. Douglas S. Can Fam Physician. 2002 Nov;48:1789-97. Premenstrual syndrome. Evidence-based treatment in family practice
    Calcium carbonate should be recommended as first-line therapy for women with mild-to-moderate PMS. Selective serotonin reuptake inhibitors can be considered as first-line therapy for women with severe affective symptoms and for women with milder symptoms who have failed to respond to other therapies. Other therapies may be tried if these measures fail to provide adequate relief.[Article]
  15. Thys-Jacobs S, Alvir MJ. J Clin Endocrinol Metab. 1995 Jul;80(7):2227-32. Calcium-regulating hormones across the menstrual cycle: evidence of a secondary hyperparathyroidism in women with PMS
    In conclusion, we found that concentrations of total and ionized calcium significantly fluctuate during the menstrual cycle both in symptomatic and in asymptomatic women. We also found that concentrations of iPTH, 25OHD, and 1,25-(OH)2D differed between groups during specific phases of the menstrual cycle. Our data suggest that women with PMS have midcycle elevations of iPTH with a transient, secondary hyperparathyroidism.[Abstract]
  16. OTHER
  17. Bertone-Johnson ER1, Hankinson SE, Bendich A, Johnson SR, Willett WC, Manson JE. Arch Intern Med. 2005 Jun 13;165(11):1246-52. Calcium and vitamin D intake and risk of incident premenstrual syndrome
    A high intake of calcium and vitamin D may reduce the risk of PMS.[Article]
  18. RCT
  19. Khajehei M1, Abdali K, Parsanezhad ME, Tabatabaee HR. Int J Gynaecol Obstet. 2009 May;105(2):158-61. doi: 10.1016/j.ijgo.2009.01.016. Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome
    Treatment with dydrogesterone or calcium plus vitamin D had a similar effect on symptom severity in women with PMS.[Abstract]
  20. META
  21. Bolland MJ1, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR. BMJ. 2010 Jul 29;341:c3691. doi: 10.1136/bmj.c3691. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis
    Calcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.[Article]
  22. REVIEW
  23. Seelig MS. Magnes Res. 1990 Sep;3(3):197-215. Increased need for magnesium with the use of combined oestrogen and calcium for osteoporosis treatment
    If the commonly recommended dietary Ca/Mg ratio of 2/1 is exceeded (and it can reach as much as 4/1 in countries with low to marginal Mg intakes), relative or absolute Mg deficiency may result, and this may increase the risk of intravascular coagulation, since blood clotting is enhanced by high Ca/Mg ratios. [Abstract]
  24. Vitamin D

    OTHER
  25. Thys-Jacobs S, McMahon D, Bilezikian JP. J Clin Endocrinol Metab. 2007 Aug;92(8):2952-9. Cyclical changes in calcium metabolism across the menstrual cycle in women with premenstrual dysphoric disorder
    Cyclical fluctuations of the calcium-regulating hormones may help us better understand some of the psychological and somatic features of PMDD. The lack of responsiveness in vitamin D metabolism resulting in a decline in 1,25(OH)(2)D during the luteal phase of the menstrual cycle may serve as the biological trigger for the classical features of PMDD.[Article]
  26. Bertone-Johnson ER, Chocano-Bedoya PO, Zagarins SE, Micka AE, Ronnenberg AG. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):434-7. Dietary vitamin D intake, 25-hydroxyvitamin D3 levels and premenstrual syndrome in a college-aged population
    High dietary intake of vitamin D may reduce the risk of premenstrual syndrome (PMS), perhaps by affecting calcium levels, cyclic sex steroid hormone fluctuations, and/or neurotransmitter function. Results from this pilot study suggest that a relationship between vitamin D and PMS is possible, though larger studies are needed to further evaluate this relationship and to investigate whether 25-hydroxyvitamin D3 levels in the follicular or early luteal phases of the menstrual cycle may be related to PMS risk.[Abstract]
  27. Bertone-Johnson ER1, Chocano-Bedoya PO, Zagarins SE, Micka AE, Ronnenberg AG. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):434-7. doi: 10.1016/j.jsbmb.2010.03.076. Dietary vitamin D intake, 25-hydroxyvitamin D3 levels and premenstrual syndrome in a college-aged population.
    Results from this pilot study suggest that a relationship between vitamin D and PMS is possible, though larger studies are needed to further evaluate this relationship and to investigate whether 25-hydroxyvitamin D3 levels in the follicular or early luteal phases of the menstrual cycle may be related to PMS risk.[Abstract]
  28. Bertone-Johnson ER1, Hankinson SE, Forger NG, Powers SI, Willett WC, Johnson SR, Manson JE. BMC Womens Health. 2014 Apr 12;14:56. doi: 10.1186/1472-6874-14-56. Plasma 25-hydroxyvitamin D and risk of premenstrual syndrome in a prospective cohort study
    Results from prospective analyses, which were less likely influenced by this bias, suggest that higher 25OHD levels may be inversely related to the development of specific menstrual symptoms.[Article]
  29. Obeidat BA1, Alchalabi HA, Abdul-Razzak KK, Al-Farras MI. Int J Environ Res Public Health. 2012 Nov 16;9(11):4210-22. doi: 10.3390/ijerph9114210. Premenstrual symptoms in dysmenorrheic college students: prevalence and relation to vitamin D and parathyroid hormone levels
    Premenstrual symptoms are very common in young women with primary dysmenorrhea. PMS has no relation to levels of vitamin D, parathyroid hormone or dairy products consumption. Headache and social withdrawal may be affected by dairy product consumption.[Article]
  30. REVIEW
  31. Murphy PK1, Wagner CL. J Midwifery Womens Health. 2008 Sep-Oct;53(5):440-6. doi: 10.1016/j.jmwh.2008.04.014. Vitamin D and mood disorders among women: an integrative review
    This review indicates a possible biochemical mechanism occurring between vitamin D and mood disorders affecting women, warranting further studies of these variables using rigorous methodologies.[Abstract]

  32. .[Abstract]

  33. .[Abstract]

Hypericum

    RCT
  1. Canning S, Waterman M, Orsi N, Ayres J, Simpson N, Dye L. CNS Drugs. 2010 Mar;24(3):207-25. doi: 10.2165/11530120-000000000-00000. The efficacy of Hypericum perforatum (St John’s wort) for the treatment of premenstrual syndrome: a randomized, double-blind, placebo-controlled trial
    Daily treatment with Hypericum perforatum was more effective than placebo treatment for the most common physical and behavioural symptoms associated with PMS.[Abstract]
  2. Fava M, Alpert J, Nierenberg AA, Mischoulon D, Otto MW, Zajecka J, Murck H, Rosenbaum JF. J Clin Psychopharmacol. 2005 Oct;25(5):441-7. A Double-blind, randomized trial of St John’s wort, fluoxetine, and placebo in major depressive disorder
    St John’s wort was significantly more effective than fluoxetine and showed a trend toward superiority over placebo. A (25%) smaller than planned sample size is likely to account for the lack of statistical significance for the advantage (indicating a moderate effect size, d = 0.45) of St John’s wort over placebo.[Abstract]
  3. van Die MD1, Bone KM, Burger HG, Reece JE, Teede HJ. J Altern Complement Med. 2009 Sep;15(9):1045-8. doi: 10.1089/acm.2008.0539 Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis
    These results suggest a potentially significant clinical application for this phytotherapeutic combination in PMS-like symptoms among perimenopausal women.[Abstract]
  4. REVIEW
  5. Stevinson C, Ernst E. BJOG. 2000 Jul;107(7):870-6. A pilot study of Hypericum perforatum for the treatment of premenstrual syndrome
    The results of this pilot study suggest that there is scope for conducting a randomised, placebo-controlled, double-blind trial to investigate the value of hypericum as a treatment for premenstrual syndrome.[Abstract]
  6. Depression

    META
  7. Rahimi R1, Nikfar S, Abdollahi M. Prog Neuropsychopharmacol Biol Psychiatry. 2009 Feb 1;33(1):118-27. doi: 10.1016/j.pnpbp.2008.10.018. Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis
    Hypericum does not differ from SSRIs according to efficacy and adverse events in MDD. Lower withdrawal from study due to adverse events by Hypericum is an advantage in management of MDD.[Abstract]
  8. Kasper S1, Gastpar M, Müller WE, Volz HP, Dienel A, Kieser M, Möller HJ. Eur Arch Psychiatry Clin Neurosci. 2008 Feb;258(1):59-63. Efficacy of St. John’s wort extract WS 5570 in acute treatment of mild depression: a reanalysis of data from controlled clinical trials
    The analysis shows that St. John’s wort extract WS 5570 has a meaningful beneficial effect during acute treatment of patients suffering from mild depression and leads to a substantial increase in the probability of remission.[Abstract]
  9. Kasper S1, Gastpar M, Möller HJ, Müller WE, Volz HP, Dienel A, Kieser M. Int Clin Psychopharmacol. 2010 Jul;25(4):204-13. Better tolerability of St. John’s wort extract WS 5570 compared to treatment with SSRIs: a reanalysis of data from controlled clinical trials in acute major depression
    In conclusion, WS 5570 exhibits substantially lower incidence rates of adverse events than paroxetine and other SSRIs.[Abstract]
  10. Food Cravings

    OTHER
  11. Yen JY1, Chang SJ, Ko CH, Yen CF, Chen CS, Yeh YC, Chen CC. Psychoneuroendocrinology. 2010 Sep;35(8):1203-12. doi: 10.1016/j.psyneuen.2010.02.006. The high-sweet-fat food craving among women with premenstrual dysphoric disorder: emotional response, implicit attitude and rewards sensitivity
    These results would suggest emotional response and implicit attitude might play a role for high-sweet-fat food craving of PMDD.[Abstract]
  12. REVIEW
  13. Møller SE. Pharmacol Toxicol. 1992;71 Suppl 1:61-71. Serotonin, carbohydrates, and atypical depression
    Based on these findings it has been suggested that the excessive carbohydrate intake by patients with PMS and SAD reflects a self-medication that temporarily relieves the vegetative symptoms via an increased central serotonergic activity.[Abstract]
  14. CLINICAL
  15. Sayegh R1, Schiff I, Wurtman J, Spiers P, McDermott J, Wurtman R. Obstet Gynecol. 1995 Oct;86(4 Pt 1):520-8. The effect of a carbohydrate-rich beverage on mood, appetite, and cognitive function in women with premenstrual syndrome
    The results suggest that the psychological and appetitive symptoms of PMS can be relieved after consuming a specially-formulated, carbohydrate-rich beverage known to increase serum tryptophan levels.[Abstract]
  16. REVIEW
  17. Wurtman JJ. Drugs. 1990;39 Suppl 3:49-52. Carbohydrate craving. Relationship between carbohydrate intake and disorders of mood
    Studies with dietary treatment or drugs that enhance serotoninergic neurotransmission have found that increased serotonin neurotransmission is associated with normalised food intake and mood. These results suggest that periodic intervention with dietary or drug treatment that increases serotonin availability may help sustain weight or assist in weight loss.[Abstract]
  18. Bijwerkingen

  19. Schulz V. Phytomedicine. 2006 Feb;13(3):199-204. Safety of St. John’s Wort extract compared to synthetic antidepressants
    As with synthetic antidepressants, pharmacokinetic interactions may occur occasionally as a result of activity changes of drug-metabolising and drug-transporting proteins, especially CYP 3A4 and P-gp. Risks to the patient are not caused by SWE but by drugs with a narrow therapeutic range.[Abstract]
  20. Zhou S1, Chan E, Pan SQ, Huang M, Lee EJ. J Psychopharmacol. 2004 Jun;18(2):262-76. Pharmacokinetic interactions of drugs with St John’s wort
    Data from human studies and case reports indicate that St John’s wort decreased the blood concentrations of amitriptyline, cyclosporine, digoxin, fexofenadine, indinavir, methadone, midazolam, nevirapine, phenprocoumon, simvastatin, tacrolimus, theophylline and warfarin, whereas it did not alter the pharmacokinetics of carbamazepine, dextromethorphan, mycophenolic acid and pravastatin. St John’s wort caused breakthrough bleeding and unplanned pregnancies when used concomitantly with oral contraceptives. It also caused serotonin syndrome when coadministered with selective serotonin-reuptake inhibitors (e.g. sertaline and paroxetine).[Abstract]
  21. Markowitz JS1, DeVane CL. Psychopharmacol Bull. 2001 Winter;35(1):53-64. The emerging recognition of herb-drug interactions with a focus on St. John’s wort (Hypericum perforatum)
    Examples of conventional medications which may undergo significant CYP 3A4 induction by St. John’s wort include cyclosporine, indinavir, and oral contraceptives..[Abstract]

  22. .[Abstract]

Vitex agnus castus

    RCT
  1. Schellenberg R1, Zimmermann C, Drewe J, Hoexter G, Zahner C. Phytomedicine. 2012 Nov 15;19(14):1325-31. doi: 10.1016/j.phymed.2012.08.006 Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome
    This study demonstrated that the VAC extract Ze 440 was effective in relieving symptoms of PMS, when applied in a dose of 20mg. Therefore, for patients suffering from PMS, 20mg Ze 440 should be the preferred daily dose.[Abstract]
  2. Zamani M1, Neghab N, Torabian S. Acta Med Iran. 2012;50(2):101-6. Therapeutic effect of Vitex agnus castus in patients with premenstrual syndrome
    Vitex agnus can be considered as an effective and well tolerated treatment for the relief of symptoms of mild and moderate PMS.[Article]
  3. Ciotta L1, Pagano I, Stracquadanio M, Di Leo S, Andò A, Formuso C. Minerva Ginecol. 2011 Jun;63(3):237-45. Psychic aspects of the premenstrual dysphoric disorders. New therapeutic strategies: our experience with Vitex agnus castus
    This study confirms the data reported in the literature regarding the effectiveness of VAC therapy with no side effects.[Abstract]
  4. Atmaca M1, Kumru S, Tezcan E. Hum Psychopharmacol. 2003 Apr;18(3):191-5. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder
    This preliminary study suggests that patients with PMDD respond well to treatment with both fluoxetine and AC. However, fluoxetine was more effective for psychological symptoms while the extract diminished the physical symptoms.[Abstract]
  5. Halaska M1, Raus K, B?les P, Martan A, Paithner KG. Ceska Gynekol. 1998 Oct;63(5):388-92. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo
    Intensity of breast pain diminished quicker with VACS group. The tolerability was satisfactory. We found VACS to be useful in the treatment of cyclical breast pain in women.[Abstract]
  6. Ma L, Lin S, Chen R, Wang X. Gynecol Endocrinol. 2010 Aug;26(8):612-6. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women
    Vitex agnus castus extract BNO 1095 shows effective in treating moderate to severe PMS in Chinese women, especially in symptoms of negative affect and water retention.[Abstract]
  7. Schellenberg R. BMJ. 2001 Jan 20;322(7279):134-7. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study
    Dry extract of agnus castus fruit is an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome.[Article]
  8. Loch EG, Selle H, Boblitz N. J Womens Health Gend Based Med. 2000 Apr;9(3):315-20. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus
    Hence, the risk/benefit ratio of the new Vitex preparation can be rated as very good, with significant efficacy for all aspects of the multifaceted and inhomogeneous clinical picture of PMS, with a safety profile comparable to other Vitex preparations.[Abstract]
  9. Ma L, Lin S, Chen R, Zhang Y, Chen F, Wang X. Aust N Z J Obstet Gynaecol. 2010 Apr;50(2):189-93. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women
    Vitex agnus castus is more effective than placebo in the treatment of moderate-to-severe PMS in Chinese women, especially in symptoms of negative effect and insomnia.[Abstract]
  10. He Z, Chen R, Zhou Y, Geng L, Zhang Z, Chen S, Yao Y, Lu J, Lin S. Maturitas. 2009 May 20;63(1):99-103. Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China
    Vitex agnus castus (VAC BNO 1095 corresponding to 40mg herbal drug) is a safe, well tolerated and effective drug of the treatment for Chinese women with the moderate to severe PMS.[Abstract]
  11. van Die MD1, Bone KM, Burger HG, Reece JE, Teede HJ. J Altern Complement Med. 2009 Sep;15(9):1045-8. doi: 10.1089/acm.2008.0539 Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis
    These results suggest a potentially significant clinical application for this phytotherapeutic combination in PMS-like symptoms among perimenopausal women.[Abstract]
  12. SYSTEMATIC REVIEW
  13. van Die MD1, Burger HG, Teede HJ, Bone KM. Planta Med. 2013 May;79(7):562-75. doi: 10.1055/s-0032-1327831. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials
    Despite some methodological limitations, the results from randomised, controlled trials to date suggest benefits for Vitex extracts in the treatment of premenstrual syndrome, premenstrual dysphoric disorder and latent hyperprolactinaemia.[Abstract]
  14. Daniele C1, Thompson Coon J, Pittler MH, Ernst E. Drug Saf. 2005;28(4):319-32. Vitex agnus castus: a systematic review of adverse events
    Although further rigorous studies are needed to assess the safety of VAC, the data available seem to indicate that VAC is a safe herbal medicine.[Abstract]
  15. REVIEW
  16. Döll M. Med Monatsschr Pharm. 2009 May;32(5):186-91. The premenstrual syndrome: effectiveness of Vitex agnus castus
    Different clinical investigations and double blind trials have shown that preparations containing Vitex agnus castus fruit extract are a useful tool to decrease pathophysiologicaly increased prolactin serum levels and though could be an effective treatment for women suffering from premenstrual syndrome.[Abstract]
  17. Daniele C, Thompson Coon J, Pittler MH, Ernst E. Drug Saf. 2005;28(4):319-32. Vitex agnus castus: a systematic review of adverse events
    The most frequent adverse events are nausea, headache, gastrointestinal disturbances, menstrual disorders, acne, pruritus and erythematous rash. No drug interactions were reported. Use of VAC should be avoided during pregnancy or lactation.[Abstract]
  18. CLINICAL
  19. Berger D, Schaffner W, Schrader E, Meier B, Brattström A. Arch Gynecol Obstet. 2000 Nov;264(3):150-3. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)
    In conclusion, patients with PMS can be treated successfully with Vitex agnus-castus extract Ze 440, as indicated by clear improvement in the main effect parameter during treatment and the gradual return after cessation of treatment. The main response to treatment seems related to symptomatic relief rather than to the duration of the syndrome.[Abstract]
  20. Ambrosini A1, Di Lorenzo C, Coppola G, Pierelli F. Acta Neurol Belg. 2013 Mar;113(1):25-9. doi: 10.1007/s13760-012-0111-4. Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation
    Concerning migraine, 42 % of patients experienced a reduction higher than 50 % in frequency of monthly attacks, and 57 % of patients experienced a reduction higher than 50 % in monthly days with headache.[Abstract]
  21. OTHER
  22. Webster DE, Lu J, Chen SN, Farnsworth NR, Wang ZJ. J Ethnopharmacol. 2006 Jun 30;106(2):216-21. Activation of the mu-opiate receptor by Vitex agnus-castus methanol extracts: implication for its use in PMS
    These results suggested for the first time that VAC acted as an agonist at the mu-opiate receptor, supporting its beneficial action in PMS.[Abstract]
  23. Webster DE1, Lu J, Chen SN, Farnsworth NR, Wang ZJ. J Ethnopharmacol. 2006 Jun 30;106(2):216-21. Activation of the mu-opiate receptor by Vitex agnus-castus methanol extracts: implication for its use in PMS
    These results suggested for the first time that VAC acted as an agonist at the mu-opiate receptor, supporting its beneficial action in PMS.[Abstract]
  24. Webster DE1, He Y, Chen SN, Pauli GF, Farnsworth NR, Wang ZJ. Biochem Pharmacol. 2011 Jan 1;81(1):170-7. doi: 10.1016/j.bcp.2010.09.013. Opioidergic mechanisms underlying the actions of Vitex agnus-castus L
    Compounds, fractions, and extracts isolated from VAC were used in this study to thoroughly investigate possible opioidergic activity. First, an extract of VAC was found to bind and activate ?- and ?-, but not ?-opioid receptor subtypes (MOR, DOR, and KOR respectively).[Article]

  25. .[Abstract]

Tryptophan

    RCT
  1. Menkes DB, Coates DC, Fawcett JP. J Affect Disord. 1994 Sep;32(1):37-44. Acute tryptophan depletion aggravates premenstrual syndrome
    This result supports other evidence implicating serotonin in premenstrual syndrome.[Abstract]
  2. Bond AJ1, Wingrove J, Critchlow DG. Psychopharmacology (Berl). 2001 Aug;156(4):477-80. Tryptophan depletion increases aggression in women during the premenstrual phase.
    Decreased serotonergic neurotransmission increases aggression in women as well as men.[Abstract]
  3. Schmitt JA, Jorissen BL, Dye L, Markus CR, Deutz NE, Riedel WJ. J Psychopharmacol. 2005 Jul;19(4):375-84. Memory function in women with premenstrual complaints and the effect of serotonergic stimulation by acute administration of an alpha-lactalbumin protein
    The data suggest that serotonergic hypofunction may play a role in premenstrual memory decline, but serotonergic mechanisms cannot fully account for observed cognitive changes in the premenstrual phase.[Abstract]
  4. OTHER
  5. Wurtman RJ, Wurtman JJ. Appetite. 1986;7 Suppl:99-103. Carbohydrate craving, obesity and brain serotonin
    A carbohydrate-rich, protein-poor meal stimulates insulin secretion; this diminishes plasma levels of the amino acids which compete with tryptophan for transport into the brain (e.g., leucine, isoleucine and valine), thus increasing tryptophan’s flux across the blood-brain barrier and its brain levels.[Abstract]
  6. CLINICAL
  7. Sayegh R1, Schiff I, Wurtman J, Spiers P, McDermott J, Wurtman R. Obstet Gynecol. 1995 Oct;86(4 Pt 1):520-8. The effect of a carbohydrate-rich beverage on mood, appetite, and cognitive function in women with premenstrual syndrome
    The results suggest that the psychological and appetitive symptoms of PMS can be relieved after consuming a specially-formulated, carbohydrate-rich beverage known to increase serum tryptophan levels.[Abstract]
  8. MULTICENTER
  9. Murakami K1, Sasaki S, Takahashi Y, Uenishi K, Watanabe T, Kohri T, Yamasaki M, Watanabe R, Baba K, Shibata K, Takahashi T, Hayabuchi H, Ohki K, Suzuki J. Nutrition. 2008 Jun;24(6):554-61. doi: 10.1016/j.nut.2008.02.003. Dietary glycemic index is associated with decreased premenstrual symptoms in young Japanese women
    Dietary GI was independently associated with decreased premenstrual symptoms in a group of young Japanese women.[Abstract]
  10. REVIEW
  11. Wurtman RJ1, Wurtman JJ. Obes Res. 1995 Nov;3 Suppl 4:477S-480S. Brain serotonin, carbohydrate-craving, obesity and depression
    Hence many patients learn to overeat carbohydrates (particularly snack foods, like potato chips or pastries, which are rich in carbohydrates and fats) to make themselves feel better. This tendency to use certain foods as though they were drugs is a frequent cause of weight gain, and can also be seen in patients who become fat when exposed to stress, or in women with premenstrual syndrome.[Abstract]
  12. RCT
  13. Steinberg S1, Annable L, Young SN, Liyanage N. Biol Psychiatry. 1999 Feb 1;45(3):313-20. A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria
    These results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.[Abstract]
  14. Steinberg S, Annable L, Young SN, Liyanage N. Adv Exp Med Biol. 1999;467:85-8. A placebo-controlled study of the effects of L-tryptophan in patients with premenstrual dysphoria
    These results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle is therapeutic in patients with premenstrual dysphoric disorder.[Abstract]
  15. OTHER
  16. Steinberg S1, Annable L, Young SN, Bélanger MC. J Psychiatry Neurosci. 1994 Mar;19(2):114-9. Tryptophan in the treatment of late luteal phase dysphoric disorder: a pilot study
    These data suggest that L-tryptophan should be tested at a dose of six grams of L-tryptophan per day in a placebo-controlled study in patients with late luteal phase dysphoric disorder who suffer from symptoms such as depression, irritability, insomnia and carbohydrate craving, which may respond to potentiation of serotonin function.[Article]
  17. Wurtman JJ1, Brzezinski A, Wurtman RJ, Laferrere B. Am J Obstet Gynecol. 1989 Nov;161(5):1228-34. Effect of nutrient intake on premenstrual depression
    Because synthesis of brain serotonin, which is known to be involved in mood and appetite, increases after carbohydrate intake, premenstrual syndrome subjects may overconsume carbohydrates in an attempt to improve their dysphoric mood state.[Abstract]

  18. .[Abstract]

Magnesium

    RCT
  1. Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA. J Womens Health. 1998 Nov;7(9):1157-65. Magnesium supplementation alleviates premenstrual symptoms of fluid retention
    A daily supplement of 200 mg of Mg (as MgO) reduced mild premenstrual symptoms of fluid retention in the second cycle of administration.[Abstract]
  2. Facchinetti F, Borella P, Sances G, Fioroni L, Nappi RE, Genazzani AR. Obstet Gynecol. 1991 Aug;78(2):177-81. Oral magnesium successfully relieves premenstrual mood changes
    These data indicate that Mg supplementation could represent an effective treatment of premenstrual symptoms related to mood changes.[Abstract]
  3. CLINICAL
  4. Quaranta S1, Buscaglia MA, Meroni MG, Colombo E, Cella S. Clin Drug Investig. 2007;27(1):51-8. Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome
    We concluded that modified-release magnesium was effective in reducing premenstrual symptoms in women with PMS in this preliminary study.[Abstract]
  5. REVIEW
  6. Serefko A1, Szopa A, Wla? P, Nowak G, Radziwo?-Zaleska M, Skalski M, Poleszak E. Pharmacol Rep. 2013;65(3):547-54. Magnesium in depression
    Thus, magnesium preparations seem to be a valuable addition to the pharmacological armamentarium for management of depression.[Article]
  7. META
  8. Sun-Edelstein C1, Mauskop A. Clin J Pain. 2009 Jun;25(5):446-52. doi: 10.1097/AJP.0b013e31819a6f65. Foods and supplements in the management of migraine headaches
    We also recommend the use of the following supplements in the preventative treatment of migraines, in decreasing order of preference: magnesium, Petasites hybridus, feverfew, coenzyme Q10, riboflavin, and alpha lipoic acid.[Abstract]

  9. .[Abstract]

SSRIs

    REVIEW
  1. Moline ML Clin Pharm. 1993 Mar;12(3):181-96. Pharmacologic strategies for managing premenstrual syndrome
    Pharmacologic treatments proposed for PMS include (1) hormonal treatments that alter the menstrual cycle, (2) hormonal treatments based on specific proposed etiologies, (3) drugs that affect fluid balance, (4) inhibitors or precursors of prostaglandins, (5) nutritional supplements, (6) psychotropic medications, and (7) nonprescription preparations. The menstrual cycle can be manipulated with transdermal estrogen and cyclic oral progesterone, oral contraceptives, danazol, or gonadotropin-releasing hormone agonists with steroid hormone replacement. Psychological symptoms may be treated with fluoxetine, clomipramine, or alprazolam. Patients may be given a diuretic for fluid retention; bromocriptine, tamoxifen, or danazol for mastodynia; and nonprescription analgesics for headaches. PMS can be managed through (1) a symptom-oriented management approach or (2) modification of the menstrual cycle. Pharmacotherapy should be initiated only after simpler measures have failed, and the medication must be chosen carefully, with the severity of the impairment weighed against adverse effects of the treatment.[Abstract]
  2. META
  3. Marjoribanks J1, Brown J, O’Brien PM, Wyatt K. Cochrane Database Syst Rev. 2013 Jun 7;6:CD001396. doi: 10.1002/14651858.CD001396.pub3. Selective serotonin reuptake inhibitors for premenstrual syndrome
    SRIs are effective in reducing the symptoms of PMS, whether taken in the luteal phase only or continuously. Adverse effects are relatively frequent, the most common being nausea and asthenia. Adverse effects are dose-dependent.[Abstract]
  4. Shah NR1, Jones JB, Aperi J, Shemtov R, Karne A, Borenstein J. Obstet Gynecol. 2008 May;111(5):1175-82. doi: 10.1097/AOG.0b013e31816fd73b. Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder: a meta-analysis
    Selective serotonin reuptake inhibitors were found to be effective in treating premenstrual symptoms, with continuous dosing regimens favored for effectiveness.[Article]
  5. Brown J, O’ Brien PM, Marjoribanks J, Wyatt K. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD001396. Selective serotonin reuptake inhibitors for premenstrual syndrome
    The evidence supports the use of selective serotonin reuptake inhibitors in the management of severe premenstrual syndrome.[Abstract]
  6. Rapkin AJ1, Mikacich JA. Paediatr Drugs. 2013 Jun;15(3):191-202. doi: 10.1007/s40272-013-0018-4. Premenstrual dysphoric disorder and severe premenstrual syndrome in adolescents
    Serotonergic agonists are a first-line therapy for adults, and some serotonin reuptake inhibitors such as fluoxetine and escitalopram can be administered safely to teens.[Abstract]
  7. Jarvis CI1, Lynch AM, Morin Ann Pharmacother. 2008 Jul;42(7):967-78. doi: 10.1345/aph.1K673. Management strategies for premenstrual syndrome/premenstrual dysphoric disorder
    Selective serotonin-reuptake inhibitors (SSRIs) have been proven safe and effective for the treatment of PMDD and are recommended as first-line agents when pharmacotherapy is warranted.[Abstract]
  8. Oral Contraceptive

    META
  9. Lopez LM1, Kaptein AA, Helmerhorst FM. Cochrane Database Syst Rev. 2012 Feb 15;2:CD006586. doi: 10.1002/14651858.CD006586.pub4. Oral contraceptives containing drospirenone for premenstrual syndrome
    Drospirenone 3 mg plus ethinyl estradiol 20 ?g may help treat premenstrual symptoms in women with severe symptoms, that is, premenstrual dysphoric disorder.[Abstract]
  10. RCT
  11. Marr J1, Niknian M, Shulman LP, Lynen R. Contraception. 2011 Jul;84(1):81-6. doi: 10.1016/j.contraception.2010.10.010. Premenstrual dysphoric disorder symptom cluster improvement by cycle with the combined oral contraceptive ethinylestradiol 20 mcg plus drospirenone 3 mg administered in a 24/4 regimen
    Ethinylestradiol 20 mcg/drospirenone 3 mg 24/4 improved commonly recognizable PMDD symptom clusters relating to negative emotions, food cravings and water retention-related symptoms to a significantly greater extent than placebo during all three cycles of treatment.[Abstract]
  12. Pearlstein TB1, Bachmann GA, Zacur HA, Yonkers KA. Contraception. 2005 Dec;72(6):414-21. Treatment of premenstrual dysphoric disorder with a new drospirenone-containing oral contraceptive formulation
    Drospirenone/EE, given in a 24/4 regimen, was superior to placebo for improving symptoms associated with PMDD.[Abstract]
  13. Yonkers KA1, Brown C, Pearlstein TB, Foegh M, Sampson-Landers C, Rapkin A. Obstet Gynecol. 2005 Sep;106(3):492-501. Efficacy of a new low-dose oral contraceptive with drospirenone in premenstrual dysphoric disorder
    A 24/4 regimen of drospirenone 3 mg and ethinyl estradiol 20 mug improves symptoms associated with premenstrual dysphoric disorde.[Abstract]
  14. Freeman EW. Eur J Contracept Reprod Health Care. 2002 Dec;7 Suppl 3:27-34; discussion 42-3. Evaluation of a unique oral contraceptive (Yasmin) in the management of premenstrual dysphoric disorder
    These preliminary results suggest the beneficial effect of DRSP/EE on PMDD and offer an alternative class of medication that also provides the range of benefits of oral contraception for women with PMDD.[Abstract]
  15. Halbreich U1, Freeman EW, Rapkin AJ, Cohen LS, Grubb GS, Bergeron R, Smith L, Mirkin S, Constantine GD. Author information Contraception. 2012 Jan;85(1):19-27. doi: 10.1016/j.contraception.2011.05.008. Continuous oral levonorgestrel/ethinyl estradiol for treating premenstrual dysphoric disorder
    Continuous daily LNG 90 mcg/EE 20 mcg was well tolerated and may be useful for managing the physical, psychological and behavioral symptoms and loss of work productivity related to PMDD.[Abstract]
  16. Progesterone creme

    RCT
  17. Segebladh B, Borgström A, Nyberg S, Bixo M, Sundström-Poromaa I. Am J Obstet Gynecol. 2009 Aug;201(2):139.e1-8. Evaluation of different add-back estradiol and progesterone treatments to gonadotropin-releasing hormone agonist treatment in patients with premenstrual dysphoric disorder
    Based on the findings of the present study, long-cycle add-back treatment to avoid frequent progestagen use appears to be most beneficial for patients with premenstrual dysphoric disorder.[Abstract]
  18. Baker ER, Best RG, Manfredi RL, Demers LM, Wolf GC. J Assist Reprod Genet. 1995 Mar;12(3):205-9. Efficacy of progesterone vaginal suppositories in alleviation of nervous symptoms in patients with premenstrual syndrome
    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.[Abstract]
  19. Dennerstein L, Spencer-Gardner C, Gotts G, Brown JB, Smith MA, Burrows GD. Br Med J (Clin Res Ed). 1985 Jun 1;290(6482):1617-21. Progesterone and the premenstrual syndrome: a double blind crossover trial
    Maximum improvement occurred in the first month of treatment with progesterone. Nevertheless, an appreciably beneficial effect of progesterone over placebo for mood and some physical symptoms was identifiable after both one and two months of treatment. Further studies are needed to determine the optimum duration of treatment.[Abstract]

Essential Fatty Acids

    RCT
  1. Sohrabi N1, Kashanian M, Ghafoori SS, Malakouti SK. Complement Ther Med. 2013 Jun;21(3):141-6. doi: 10.1016/j.ctim.2012.12.008. Evaluation of the effect of omega-3 fatty acids in the treatment of premenstrual syndrome: “a pilot trial”
    It appears that omega-3 fatty acids may reduce the psychiatric symptoms of PMS including depression, nervousness, anxiety, and lack of concentration and may also reduce the somatic symptoms of PMS including bloating, headache and breast tenderness. These effects increased by longer duration of treatment.[Abstract]
  2. Rocha Filho EA1, Lima JC, Pinho Neto JS, Montarroyos U. Reprod Health. 2011 Jan 17;8:2. doi: 10.1186/1742-4755-8-2. Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study
    The difference between the groups using the medication and the placebo group with respect to the improvement in symptomatology appears to indicate the effectiveness of the drug. Improvement in symptoms was higher when the 2-gram dose was used. This medication was not associated with any changes in prolactin or total cholesterol levels in these women.[Article]
  3. CLINICAL
  4. Horrobin DF. J Reprod Med. 1983 Jul;28(7):465-8. The role of essential fatty acids and prostaglandins in the premenstrual syndrome
    There is evidence that prostaglandin E1, derived from dietary essential fatty acids, is able to attenuate the biologic actions of prolactin and that in the absence of prostaglandin E1 prolactin has exaggerated effects. Attempts were made, therefore, to treat women who had the premenstrual syndrome with gamma-linolenic acid, an essential fatty acid precursor of prostaglandin E1. Nutrients known to increase the conversion of essential fatty acids to prostaglandin E1 include magnesium, pyridoxine, zinc, niacin and ascorbic acid. The clinical success obtained with some of these nutrients may in part relate to their effects on essential fatty acid metabolism.[Abstract]
  5. Puolakka J, Mäkäräinen L, Viinikka L, Ylikorkala O. J Reprod Med. 1985 Mar;30(3):149-53. Biochemical and clinical effects of treating the premenstrual syndrome with prostaglandin synthesis precursors
    The data suggest that prostaglandins might play a role in the pathophysiology of the premenstrual syndrome.[Abstract]
  6. OTHER
  7. Koshikawa N1, Tatsunuma T, Furuya K, Seki K. Prostaglandins Leukot Essent Fatty Acids. 1992 Jan;45(1):33-6. Prostaglandins and premenstrual syndrome
    A disturbance of PG metabolism may contribute to the etiology of PMS.[Abstract]
  8. CLINICAL
  9. Collins A1, Cerin A, Coleman G, Landgren BM. Obstet Gynecol. 1993 Jan;81(1):93-8. Essential fatty acids in the treatment of premenstrual syndrome
    Treatment with essential fatty acids is ineffective therapy for PMS. The improvement we observed over time can be ascribed to either a placebo effect or participation in the study.[Abstract]
  10. CLINICAL
  11. Khoo SK1, Munro C, Battistutta D. Med J Aust. 1990 Aug 20;153(4):189-92. Evening primrose oil and treatment of premenstrual syndrome
    These findings indicate that the improvement experienced by these women with moderate PMS was solely a placebo effect.[Abstract]
  12. EPA / DHA

    RCT
  13. Sampalis F, Bunea R, Pelland MF, Kowalski O, Duguet N, Dupuis S. Altern Med Rev. 2003 May;8(2):171-9. Evaluation of the effects of Neptune Krill Oil on the management of premenstrual syndrome and dysmenorrhea
    Neptune Krill Oil can significantly reduce dysmenorrhea and the emotional symptoms of premenstrual syndrome and is shown to be significantly more effective for the complete management of premenstrual symptoms compared to omega-3 fish oil.[Article]
  14. META
  15. Sublette ME1, Ellis SP, Geant AL, Mann JJ J Clin Psychiatry. 2011 Dec;72(12):1577-84. doi: 10.4088/JCP.10m06634. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression
    Supplements containing EPA ? 60% of total EPA + DHA, in a dose range of 200 to 2,200 mg/d of EPA in excess of DHA, were effective against primary depression. Translational studies are needed to determine the mechanisms of EPA’s therapeutic benefit.[Article]
  16. Martins JG. J Am Coll Nutr. 2009 Oct;28(5):525-42. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials
    The current meta-analysis provides evidence that EPA may be more efficacious than DHA in treating depression.[Abstract]

  17. .[Abstract]

Isoflavones

  1. Bryant M, Cassidy A, Hill C, Powell J, Talbot D, Dye L. Br J Nutr. 2005 May;93(5):731-9. Effect of consumption of soy isoflavones on behavioural, somatic and affective symptoms in women with premenstrual syndrome
    The present study showed that ISP containing IF may have potential to reduce specific premenstrual symptoms via non-classical actions.[Abstract]
  2. Christie S, Walker AF, Hicks SM, Abeyasekera S. Phytomedicine. 2004 Jan;11(1):11-7. Flavonoid supplement improves leg health and reduces fluid retention in pre-menopausal women in a double-blind, placebo-controlled study
    We conclude that flavonoids supplements may provide a new therapeutic direction to counter premenstrual fluid retention and improve leg health. A larger study is now warranted.[Abstract]

B6

  1. Doll H, Brown S, Thurston A, Vessey J R Coll Gen Pract. 1989 Sep;39(326):364-8. Pyridoxine (vitamin B6) and the premenstrual syndrome: a randomized crossover trial
    Based on the results of this study, pyridoxine appears to alleviate premenstrual depression. Further research is needed to confirm the results of this and other similar studies.[Article]
  2. Wyatt KM, Dimmock PW, Jones PW, Shaughn O’Brien PM. BMJ. 1999 May 22;318(7195):1375-81. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review
    Conclusions are limited by the low quality of most of the trials included. Results suggest that doses of vitamin B-6 up to 100 mg/day are likely to be of benefit in treating premenstrual symptoms and premenstrual depression.[Article]

  3. .[Abstract]

Ginkgo Biloba

    RCT
  1. Ozgoli G, Selselei EA, Mojab F, Majd HA. J Altern Complement Med. 2009 Aug;15(8):845-51. A randomized, placebo-controlled trial of Ginkgo biloba L. in treatment of premenstrual syndrome
    G. biloba L. can reduce the severity of PMS symptoms. Further research on active ingredients and also the efficacy and safety of various doses and treatment durations of Ginkgo are required.[Abstract]
  2. Tamborini A, Taurelle R. Rev Fr Gynecol Obstet. 1993 Jul-Sep;88(7-9):447-57. Value of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndrome
    With a good acceptability, EGb 761 was effective against the congestive symptoms of PMS, particularly breast symptoms with a statistical significance between EGb 761 and placebo. Neuropsychological symptoms were also improved. EGb 761 is an alternative of interest to therapeutics already used in treating PMS or can be associated without any inconvenience.[Abstract]

Nutrition

    REVIEW
  1. Møller SE. Pharmacol Toxicol. 1992;71 Suppl 1:61-71. Serotonin, carbohydrates, and atypical depression
    Based on these findings it has been suggested that the excessive carbohydrate intake by patients with PMS and SAD reflects a self-medication that temporarily relieves the vegetative symptoms via an increased central serotonergic activity.[Abstract]

  2. .[Abstract]

  3. .[Abstract]