A comparison of hormone therapy, coping skills training, and relaxation for the relief of premenstrual syndrome

Abstract

Approximately 10% of women are severely affected by premenstrual syndrome (PMS) during their reproductive years. Several biological theories of causation have been proposed and each has provoked treatment attempts through medication to little sustained effect. As many of the reported complaints are psychological, a new treatment approach was considered using cognitive-behavioral therapy. A preliminary study which combined cognitive-behavioral therapy with drug treatment produced considerable symptom reduction. The present study examined the efficacy of cognitive-behavioral therapy alone in direct comparison with hormone treatment. Relaxation instructions were provided to a control group. Initial rapid responses to drug treatment and relaxation diminishes after 2 months, together with marked attrition in the control group. Significant positive benefits from cognitive-behavioral therapy were achieved after the first treatment month that continued throughout and were maintained at follow-up 3 months later. Implications for future management are discussed.

Dydrogesterone increases allopregnanolone in selected brain areas and in serum of female rats

“…Thus, improvement of mood symptoms and anxiety after DYD administration (18)(19)(20) can be dependent, at least in part, on an increased level of allopregnanolone.…”

“…The administration of DYD in fertile women affected by moderate to severe premenstrual syndrome was more effective than placebo against psychological symptoms such as anxiety, tension, and irritability (18). The reduction of anxiety scores in postmenopausal women was greater in those receiving a sequential regimen of transdermal estradiol plus DYD than in those receiving norethisterone acetate (NETA) or nomegestrol acetate (NMA) (19), without affecting negatively the reduction of the depression score induced by the administration of estradiol (20).…”

Effective open‐label treatment of premenstrual dysphoric disorder with venlafaxine

“…10 These treatments and other psychosocial interventions including cognitive therapy, exercise and relaxation deserve further study. 10,11 Evidence suggests that serotonin may play an important role in the pathophysiology of PMS. [12][13][14] But other neurotransmitters and neuromodulators, in particular the gammaaminobutyric acid (GABA), adrenergic, and opioid systems, have also been implicated in the pathophysiology of PMS and PMDD.…”

Evaluation of Psychological Symptoms in Premenstrual Syndrome using PMR Technique

“…It is also reported that women utilizing CBT with relaxation instructions had significantly reduced PMS symptoms compared with women randomized to a non-active control group during two menstrual cycles [19].…”