Efficacy of progesterone vaginal suppositories in alleviation of nervous symptoms in patients with premenstrual syndrome

Baker, Elizabeth R.; Best, Robert G.; Manfredi, Rocco L.; Demers, Laurence M.; Wolf, Gordon C.

doi:10.1007/bf02211800

Cited by 40 publications

(11 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Figure 1 shows the individual standardised mean difference for each trial, the type of preparation and dosage for that trial, and the pooled standardised mean difference with 95% confidence intervals for trials that used progesterone suppositories and those that used oral micronised progesterone. The inclusion of the data from the two low quality trials 25 26 did not significantly affect the overall result.…”

Section: Resultsmentioning

confidence: 94%

See 1 more Smart Citation

Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

Wyatt

Dimmock

Jones

et al. 2001

BMJ

141

View full text Add to dashboard Cite

Objective To evaluate the efficacy of progesterone and progestogens in the management of premenstrual syndrome. Design Systematic review of published randomised, placebo controlled trials. Studies reviewed 10 trials of progesterone therapy (531 women) and four trials of progestogen therapy (378 women). Main outcome measures Proportion of women whose symptoms showed improvement with progesterone preparations (suppositories and oral micronised). Proportion of women whose symptoms showed improvement with progestogens. Secondary analysis of efficacy of progesterone and progestogens in managing physical and behavioural symptoms. Results Overall standardised mean difference for all trials that assessed efficacy of progesterone (by both routes of administration) was − 0.028 (95% confidence interval − 0.017 to − 0.040). The odds ratio was 1.05 (1.03 to 1.08) in favour of progesterone, indicating no clinically important difference between progesterone and placebo. For progestogens the overall standardised mean was − 0.036 ( − 0.014 to − 0.060), which corresponds to an odds ratio of 1.07(1.03 to 1.11) showing a statistically, but not clinically, significant improvement for women taking progestogens. Conclusion The evidence from these meta-analyses does not support the use of progesterone or progestogens in the management of premenstrual syndrome.

show abstract

Section: Resultsmentioning

confidence: 94%

“…We excluded four: two because of their low quality score on the Jadad scale, 26 27 one because the data could not be extracted,29 and one because the trial failed to make a prospective diagnosis of premenstrual syndrome before randomisation 24. Ten trials remained, representing 531 women with data suitable for inclusion in the analyses.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

Wyatt

Dimmock

Jones

et al. 2001

BMJ

141

View full text Add to dashboard Cite

show abstract

“…In addition, several studies focussed on the putative beneficial effects of progesterone administration in patients suffering from premenstrual syndrome (PMS), which in part overlaps with depressive symptomatology. While some investigations reported an improvement of mood (Baker et al 1995;Dennerstein et al 1980;Magill 1995) in women suffering from PMS, others found no superiority to placebo treatment (Freeman et al 1990(Freeman et al , 1995Vanselow et al 1996). Moreover, no correlation between progesterone levels (Hsiao et al 2004;Schmidt et al 1994) and clinical symptoms of PMS have been detected so far.…”

Section: Progesterone In Depression and Anxiety Disordersmentioning

confidence: 99%

Neuropsychopharmacological properties of neuroactive steroids in depression and anxiety disorders

et al. 2005

View full text Add to dashboard Cite

Neuroactive steroids modulate neurotransmission through modulation of specific neurotransmitter receptors such as gamma-aminobutyric acid type A (GABAA) receptors. Preclinical studies suggested that neuroactive steroids may modulate anxiety- and depression-related behaviour and may contribute to the therapeutical effects of antidepressant drugs. Attenuations of 3alpha-reduced neuroactive steroids have been observed during major depression. This disequilibrium can be corrected by successful treatment with antidepressant drugs. However, non-pharmacological antidepressant treatment strategies did not affect neuroactive steroid composition independently from the clinical response. Further research is needed to clarify whether enhancement of neuroactive steroid levels might represent a new therapeutical approach in the treatment of affective disorders. Nevertheless, the first studies investigating the therapeutical effects of exogenously administered dehydroepiandosterone revealed promising results in the treatment of major depression. In addition, in various anxiety disorders alterations of neuroactive steroid levels have been observed. In panic disorder, in the absence of panic attacks, neuroactive steroid composition is opposite to that seen in depression, which may represent counter-regulatory mechanisms against the occurrence of spontaneous panic attacks. However, during experimentally induced panic attacks, there was a pronounced decline in GABAergic neuroactive steroids, which might contribute to the pathophysiology of panic attacks. In conclusion, neuroactive steroids contribute to the pathophysiology of affective disorders and the mechanisms of action of antidepressants. They are important endogenous modulators of depression and anxiety and may provide a basis for the development of novel therapeutic agents in the treatment of affective disorders.

show abstract

“…In addition, several studies focused on the putative beneficial effects of progesterone administration in patients suffering from PMS, which in part overlaps with depressive symptomatology. While some investigations reported an improvement in mood [67,68,69] in women suffering from PMS, others found no superiority to placebo treatment [70,71,72]. Furthermore, the previously recommended prophylactic postpartum use of progesterone in women who had experienced postpartum depression in the past [73] was challenged by an observed enhanced risk of postpartum depression after progesterone therapy [74].…”

Section: Therapeutic Potential Of Neuroactive Steroids In the Treatmementioning

confidence: 99%

Neuroactive Steroids in Depression and Anxiety Disorders: Clinical Studies

et al. 2006

View full text Add to dashboard Cite

Certain neuroactive steroids modulate ligand-gated ion channels via non-genomic mechanisms. Especially 3α-reduced pregnane steroids are potent positive allosteric modulators of the γ-aminobutyric acid type A (GABA_A) receptor. During major depression, there is a disequilibrium of 3α-reduced neuroactive steroids, which is corrected by clinically effective pharmacological treatment. To investigate whether these alterations are a general principle of successful antidepressant treatment, we studied the impact of nonpharmacological treatment options on neuroactive steroid concentrations during major depression. Neither partial sleep deprivation, transcranial magnetic stimulation, nor electroconvulsive therapy affected neuroactive steroid levels irrespectively of the response to these treatments. These studies suggest that the changes in neuroactive steroid concentrations observed after antidepressant pharmacotherapy more likely reflect distinct pharmacological properties of antidepressants rather than the clinical response. In patients with panic disorder, changes in neuroactive steroid composition have been observed opposite to those seen in depression. However, during experimentally induced panic induction either with cholecystokinine-tetrapeptide or sodium lactate, there was a pronounced decline in the concentrations of 3α-reduced neuroactive steroids in patients with panic disorder, which might result in a decreased GABAergic tone. In contrast, no changes in neuroactive steroid concentrations could be observed in healthy controls with the exception of 3α,5α-tetrahydrodeoxycorticosterone. The modulation of GABA_A receptors by neuroactive steroids might contribute to the pathophysiology of depression and anxiety disorders and might offer new targets for the development of novel anxiolytic compounds.

show abstract

Efficacy of progesterone vaginal suppositories in alleviation of nervous symptoms in patients with premenstrual syndrome

Cited by 40 publications

References 11 publications

Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

Neuropsychopharmacological properties of neuroactive steroids in depression and anxiety disorders

Neuroactive Steroids in Depression and Anxiety Disorders: Clinical Studies

Contact Info

Product

Resources

About