Treatment Of Premenstrual Syndrome Research Articles

Pyridoxine in the treatment of premenstrual syndrome: a retrospective survey in 630 patients

International Journal of Clinical PracticeVolume 42, Issue 11 p. 448-452 Clinical Study Pyridoxine in the treatment of premenstrual syndrome: a retrospective survey in 630 patients M G Brush PHD, Corresponding Author M G Brush PHD Senior Lecturer in Reproductive Biochemistry n/[email protected] Department of Gynaecology, St Thomas's Hospital Medical School, LondonAddress correspondence to Dr M G Brush, Department of Gynaecology, St Thomas's Hospital Medical School, London, SE1 7EH.Search for more papers by this authorT Bennett SRN, T Bennett SRN Research Assistant Department of Gynaecology, St Thomas's Hospital Medical School, LondonSearch for more papers by this authorK Hansen BA, K Hansen BA Research Assistant Department of Gynaecology, St Thomas's Hospital Medical School, LondonSearch for more papers by this author M G Brush PHD, Corresponding Author M G Brush PHD Senior Lecturer in Reproductive Biochemistry n/[email protected] Department of Gynaecology, St Thomas's Hospital Medical School, LondonAddress correspondence to Dr M G Brush, Department of Gynaecology, St Thomas's Hospital Medical School, London, SE1 7EH.Search for more papers by this authorT Bennett SRN, T Bennett SRN Research Assistant Department of Gynaecology, St Thomas's Hospital Medical School, LondonSearch for more papers by this authorK Hansen BA, K Hansen BA Research Assistant Department of Gynaecology, St Thomas's Hospital Medical School, LondonSearch for more papers by this author First published: 01 November 1988 https://doi.org/10.1111/j.1742-1241.1988.tb08625.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume42, Issue11November 1988Pages 448-452 RelatedInformation

Verapamil treatment of premenstrual syndrome

Verapamil treatment of premenstrual syndrome

An Overview of Assessment and Treatment of Premenstrual Syndrome

Premenstrual syndrome (PMS) is a commonly occurring problem that must be dealt with by both the helping and the health professions. The authors provide a brief update on recent advances in understanding and treating PMS. They emphasize points of contact among various health professionals in developing an interdisciplinary approach to intervention.

Treatment of premenstrual syndrome: A double-blind trial of dydrogesterone

A double-blind randomised crossover trial of oral micronised progesterone and placebo had demonstrated that progesterone had beneficial effects over placebo for some mood and physical premenstrual symptoms. A further trial using identical methodology was carried out to assess whether dydrogesterone would have the same beneficial effects. Prospective assessment confirmed the presence of a premenstrual syndrome in 30 women. Of these, six withdrew during the 4 months of the study. Twenty-four women completed the double-blind crossover protocol. All women were interviewed premenstrually before treatment and in each month of treatment. They completed the Moos Menstrual Distress Questionnaire, Beck Depression Inventory, Spielberger State Anxiety Inventory, Mood Adjective Checklist and a Daily Symptom Record. Analysis of data found an overall beneficial effect of being treated for most variables. Further analysis showed that the most major effects occurred in the first 2 treatment months. This study could find no evidence that dydrogesterone was more effective than placebo in treating premenstrual complaints.

Progesterone and premenstrual syndrome : Maddocks S, Hahn P, Moller F, et al: A double-blind placebo-controlled trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome. AM J OBSTET GYNECOL 154:573, 1986

Progesterone and premenstrual syndrome : Maddocks S, Hahn P, Moller F, et al: A double-blind placebo-controlled trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome. AM J OBSTET GYNECOL 154:573, 1986

Alcohol abuse in women seeking gynecologic care.

In several retrospective studies, alcoholic women have reported menstrual problems significantly more often than nonalcoholic women. There is no information, however, comparing the prevalence of alcohol abuse in women who receive periodic gynecologic care and those who seek care for menstrual disorders such as the premenstrual syndromes. This question was studied in two private practice settings. Women seeking periodic care were obtained from a suburban, general gynecology practice. Women seeking treatment for premenstrual syndrome (PMS) were obtained from a practice that specialized in the care of PMS. Ninety-five patients with PMS and 147 patients seeking periodic care were screened with the CAGE questions--a mnemonic for attempts to Cut back on drinking, being Annoyed at criticism about drinking, feeling Guilty about drinking, and using alcohol as an Eye-opener. Women who gave affirmative responses to one or more of the CAGE questions were evaluated for the presence of alcohol abuse. In the women seeking periodic care, 33% were CAGE positive and 12% were alcohol abusers. In the PMS practice, 51% were CAGE positive and 21% were alcohol abusers. Alcohol abuse is a common problem in gynecologic practice. Women who seek medical care for PMS are at much greater risk to be alcohol abusers.

A double-blind placebo-controlled trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome

Rigorous criteria were used to select women with severe premenstrual syndrome for inclusion in an 8-month double-blind placebo-controlled clinical trial of progesterone vaginal suppositories. Following a control month without treatment, progesterone (200 mg in polyethylene glycol base) or placebo was self administered twice daily by vaginal suppository for a minimum of 12 days before the onset of menstruation for 3 months. Crossover to the opposite medication for a further 3 months was followed by a final control cycle without treatment in month 8. Physician contact was minimized throughout the study to avoid any possible positive effects of psychological support which may have confounded past investigations. Detailed self-report questionnaires were completed every 3 days for the duration of the study. Although the attrition rate was high, 20 women completed the trial and their records are analyzed here. The results of this trial indicate that the response to vaginal progesterone in these dosages is, at best, marginal and not significantly different from response with placebo use.

What Are Nurses Doing to Help PMS Patients?

Premenstrual syndrome (PMS) is a hot topic these days but the disorder remains an enigma. Many women suffer, to some degree, the cyclic signs of PMS-irritability, depression, anxiety, impaired concentration, breast swelling and tenderness, headache, binge eating and/or craving for sweet or salty foods. But why? Is the cause hormonal and/or biochemical imbalance, poor nutrition, underlying psychiatric disorder, or some other unknown factor(1-3)? syndrome is defined as a complex of symptoms-somatic, behavioral, and emotional-occurring in the luteal phase. This phase usually begins in midcycle with ovulation, when the follicle is changed into corpus luteum, and ends at (or shortly after) menstruation(l). In many ways, PMS mimics dysmenorrhea; the key differences are in the timing of symptoms and in pelvic cramping. Although headache, nausea, edema, and fatigue are common to both, pelvic cramping is specific to, and the principal sign of, dysmenorrhea, which generally begins a day or two before menses and peaks in severity on the first or second day of flow. PMS has a wider variety of symptoms (150 having been identified in the literature)(4). syndrome also begins earlier in the cycle than does dysmenorrhea, and PMS is abruptly relieved at menses. An estimated 20 to 40 percent of women of childbearing age suffer some premenstrual symptoms. However, it is also believed that only 5 to 15 percent have very severe symptoms(5). Many theories have been proposed on specific etiology. An estrogen/progesterone imbalance, excessive prostaglandins, abnormal magnesium metabolism, vitamin deficiencies, reactive hypoglycemia, and neuroendocrine changes in the hypothalmic-pituitary axis are among them, but no theory has been conclusively proved(1-8). Theories on effective treatment also abound. AJN asked nurses, physicians, and researchers involved in the treatment and study of PMS what methods they used, and to what effect. It became clear that nurses are playing the key role in the management of patients with PMS, and that they can back up their advice on methods with solid evidence. Michelle Harrison, of Cambridge, Massachusetts, author of Self-Help for Premenstrual Syndrome, advises physicians that nurses are ideally qualified to handle patients with PMS(9). Guy E. Abraham, a California PMS specialist known for significant research on nutritional and vitamin treatment for the disorder, agrees: The in PMS treatment is that the patient has most of her contact with a nurse. Total nurse management is not unusual, unless a medical evaluation is necessary to rule out possible disease. predominant model might describe Mary Ann Wilson, RN, C, a nurse practitioner who has seen over 100 PMS patients in the obstetrics and gynecology department of the Kaiser Foundation Health Plan, a health maintenance organization (HMO) in East Hartford, Connecticut. department is staffed by five nurse practitioners, four physicians, and two RNs who do phone follow-up. Wilson says PMS patients are referred to the nurse practitioners. We do all the screening and counseling, unless a medical problem is indicated, or the patient requests an MD, she reports. initial PMS consult is scheduled during the patient's asymptomatic follicular phase (which runs from menses to ovulation), Wilson explained, since a PMS patient is then under less stress and she'll have much more energy to do what you suggest. Some women, says Wilson, will first call during an emergency. We'll do a 'validating' visit; we will talk and calm them and advise a visit when they don't feel so bad. If the patient seems in crisis, particularly if she is suicidal, we will send her immediately to the mental health department for counseling. Most HMO patients have had a thorough physical within six to 12 months of seeking help for PMS. nurse reviews the patient's chart for health problems that could be contributing to, or confused with, PMS. A nutritional history is taken, with particular attention to excessive alcohol, salt, and caffeine intake. Patients with a very poor Ellen Perley Frank,former editor of Clinical Aspects of High-Risk Pregnancy writes on health and science topics. cr 0

WHAT ARE NURSES DOING TO HELP PMS PATIENTS?

Premenstrual syndrome (PMS) is a hot topic these days but the disorder remains an enigma. Many women suffer, to some degree, the cyclic signs of PMS-irritability, depression, anxiety, impaired concentration, breast swelling and tenderness, headache, binge eating and/or craving for sweet or salty foods. But why? Is the cause hormonal and/or biochemical imbalance, poor nutrition, underlying psychiatric disorder, or some other unknown factor(1-3)? The syndrome is defined as a complex of symptoms-somatic, behavioral, and emotional-occurring in the luteal phase. This phase usually begins in midcycle with ovulation, when the follicle is changed into corpus luteum, and ends at (or shortly after) menstruation(l). In many ways, PMS mimics dysmenorrhea; the key differences are in the timing of symptoms and in pelvic cramping. Although headache, nausea, edema, and fatigue are common to both, pelvic cramping is specific to, and the principal sign of, dysmenorrhea, which generally begins a day or two before menses and peaks in severity on the first or second day of flow. PMS has a wider variety of symptoms (150 having been identified in the literature)(4). The syndrome also begins earlier in the cycle than does dysmenorrhea, and PMS is abruptly relieved at menses. An estimated 20 to 40 percent of women of childbearing age suffer some premenstrual symptoms. However, it is also believed that only 5 to 15 percent have very severe symptoms(5). Many theories have been proposed on specific etiology. An estrogen/progesterone imbalance, excessive prostaglandins, abnormal magnesium metabolism, vitamin deficiencies, reactive hypoglycemia, and neuroendocrine changes in the hypothalmic-pituitary axis are among them, but no theory has been conclusively proved(1-8). Theories on effective treatment also abound. AJN asked nurses, physicians, and researchers involved in the treatment and study of PMS what methods they used, and to what effect. It became clear that nurses are playing the key role in the management of patients with PMS, and that they can back up their advice on methods with solid evidence. Michelle Harrison, MD, of Cambridge, Massachusetts, author of Self-Help for Premenstrual Syndrome, advises physicians that nurses are ideally qualified to handle patients with PMS(9). Guy E. Abraham, MD, a California PMS specialist known for significant research on nutritional and vitamin treatment for the disorder, agrees: "The predominant model in PMS treatment is that the patient has most of her contact with a nurse. Total nurse management is not unusual, unless a medical evaluation is necessary to rule out possible disease." The "predominant model" might describe Mary Ann Wilson, RN, C, a nurse practitioner who has seen over 100 PMS patients in the obstetrics and gynecology department of the Kaiser Foundation Health Plan, a health maintenance organization (HMO) in East Hartford, Connecticut. The department is staffed by five nurse practitioners, four physicians, and two RNs who do phone follow-up. Wilson says PMS patients are referred to the nurse practitioners. "We do all the screening and counseling, unless a medical problem is indicated, or the patient requests an MD," she reports. The initial PMS consult is scheduled during the patient's asymptomatic follicular phase (which runs from menses to ovulation), Wilson explained, "since a PMS patient is then under less stress and she'll have much more energy to do what you suggest." Some women, says Wilson, will first call during an emergency. "We'll do a 'validating' visit; we will talk and calm them and advise a visit when they don't feel so bad. If the patient seems in crisis, particularly if she is suicidal, we will send her immediately to the mental health department for counseling." Most HMO patients have had a thorough physical within six to 12 months of seeking help for PMS. The nurse reviews the patient's chart for health problems that could be contributing to, or confused with, PMS. A nutritional history is taken, with particular attention to excessive alcohol, salt, and caffeine intake. Patients with a very poor Ellen Perley Frank,former editor of Clinical Aspects of High-Risk Pregnancy writes on health and science topics. cr 0

Premenstrual syndrome

AbstractThis paper is an overview of research on premenstrual syndrome (PMS), focusing on the key topics of definition of the syndrome and the relationship of PMS to psychiatric illness. The etiology and treatment of PMS is discussed. Medical‐legal implications of PMS are also reviewed with attention directed to the few studies and court cases relating PMS to the concept of diminished criminal responsibility. Researchers are beginning to make some progress with respect to criteria for the diagnosis of PMS. Much work remains concerning the questions of the relationship of PMS to psychiatric disorders and whether PMS should be considered as one syndrome or many.

Medical treatment of premenstrual syndrome.

Treatment of Premenstrual Syndrome has been hampered by the ongoing confusion concerning the etiology of this disorder. Lack of universally accepted diagnostic criteria has been a major factor in the inconclusive and contradictory results of most studies of treatment. Medical treatments which have been used for Premenstrual Syndrome can be divided into three major groups: those that are designed to relieve specific symptoms without attempting to modify the underlying disease process; those that presumably correct what is hypothesized as being the underlying pathophysiology of the disorder; and those that alter the normal ovulatory menstrual cycle. This paper critically reviews a multitude of proposed treatments including psychoactive drugs, diet, exercise, vitamin supplements, hormones and surgery. There is no clear cut evidence of the effectiveness of any of these medical approaches. The emphasis on medical and drug therapies should not discourage physicians from evaluating the effects of psychotherapy on symptom amelioration.

Review of the etiology and treatment of premenstrual syndrome.

Premenstrual syndrome (PMS) is a diagnostic enigma that causes significant morbidity in many woman. Numerous theories have been proposed in an attempt to explain the varied symptoms that occur cyclically in women with PMS. Suggested etiologic theories of PMS include psychological abnormalities, nutritional deficiencies, aberrations in the renin-angiotensin-aldosterone axis, altered prostaglandin activity, hormonal imbalances, and changes in endogenous opioid peptide activity. Because of the lack of standardized diagnostic criteria, clinical drug trials for PMS have been severely compromised. For every proposed cause of PMS, there exists a drug or drug class that has been investigated for treatment of the associated symptoms. Many clinical studies are uncontrolled, a significant deficiency in study design for a disorder that is associated with a high placebo response rate. At the present time, no definitive treatment for PMS exists and therapy must be individualized according to clinical response. This review article defines PMS, describes one of the current approaches to the diagnostic work-up, discusses the proposed etiologies of PMS, and reviews the various proposed treatment modalities.

PMS treatment approaches and progesterone therapy

Two hundred thirty-nine patients met the diagnostic criteria for premenstrual syndrome (PMS) or possible PMS and were first treated with multiple nonhormonal approaches. After six weeks, 35% reported good improvement. Of 107 unimproved patients who subsequently received progesterone therapy, 53% reported good improvement at the six-month follow-up. This report suggests the range of treatment responses among women who seek treatment for premenstrual symptoms, but placebo-controlled study is essential. It appears useful to provide conservative treatment initially, with the addition of hormonal therapies only when symptoms are not reduced.

Treatment of premenstrual syndrome with subcutaneous oestradiol implants - a double-blind, placebo-controlled study : A.L. Magos M. Brincat and J.W. Studd - London, U.K.

Treatment of premenstrual syndrome with subcutaneous oestradiol implants - a double-blind, placebo-controlled study : A.L. Magos M. Brincat and J.W. Studd - London, U.K.

Possible new relief for premenstrual syndrome

Treatments for premenstrual syndrome, or PMS, seem as varied as the symptoms themselves. Now to add to this diversity, Carlos Soto-Albors, MD, director of the PMS clinic and research fellow in reproductive endocrinology at the University of Connecticut Health Center, Farmington, has found in preliminary studies that 80% of 50 patients who suffer from PMS obtain relief from a new treatment, administration of spironolactone, an aldosterone antagonist. Premenstrual discomfort is characterized by one or more symptoms ranging from breast tenderness, weight gain, abdominal bloating, and headache to anxiety, irritability, crying spells, depression, and even violence ( JAMA [MEDICAL NEWS] 1981;245:1393-1396). These symptoms occur up to two weeks before menstruation in 70% to 90% of all women of childbearing age. In 5% to 40% of these women, symptoms are severe enough to substantially interfere with their lives and warrant the designation PMS. There are also connections between PMS and psychiatric illnesses ( JAMA

Recent research on the treatment of premenstrual syndrome

SummaryThe cause or causes of premenstrual syndrome are still uncertain and although there is considerable evidence that hormonal factors play an important role the research evidence is not suflcient or consistent enough to provide a reliable picture of the aetiology of the syndrome. As a result, treatment is primarily symptomatic and the results of the limited number of controlled clinical trials carried out with a variety of drug treatments, whilst showing them to be effective in between 50 % to 70% of patients in relieving certain symptoms, do not indicate the superiority of any one form of therapy. Recent research findings are briefly reviewed and management of the premenstrual syndrome patient is discussed.

Comparative trials of new oral progestogenic compounds in treatment of premenstrual syndrome.

Comparative trials of new oral progestogenic compounds in treatment of premenstrual syndrome.