The efficiency of oral contraception containing drospirenone in treating symptoms of premenstrual syndrome or premenstrual dysphoric disorder in gyneacology practice

Česká verzia

Authors: K. Svojanovská
Authors place of work: MEDICONET s. r. o., Brno
Published in the journal: Ceska Gynekol 2010; 75(5): 474-480

Summary

Purpose:
The efficiency of oral contraception containing drospirenone in treating symptoms of premenstrual dysphoric disorder (PMDD) was demonstrated in a number of studies. The objective of this observation was to use the „Premenstrual Symptoms Screening Tool“ (PSST) to identify women who suffer from severe premenstrual syndrome (PMS) or PMDD and evaluate the benefits of their treatment through using the oral contraceptive containing drospirenone in regime 24/4 in gyneacology practice.

Method:
The retrospective study was conducted from September 2008 to August 2009. Fifty-one women met by the PSST (Premenstrual Symptoms Screening Tool, Steiner et al, 2003) the criteria of severe PMS/PMDD. Twenty-eight women took no contraception at the start of the evaluation and twenty-three already took oral contraceptives before changing to the oral contraceptive with drospirenone. The women completed the PSST and in the case of severe PMS/PMDD started treatment with the oral contraceptive containing 20 μg ethinylestradiol /EE/ + 3mg drospirenone /drsp/ in regime 24/4. The next evaluation was conducted by the same PSST after 3 or 4 months of treatment with this oral contraceptive.

Results:
The study involved 51 women between the ages of 15 and 44 years (average 25,7 years), who completed the PSST before and after 3 or 4 months of treatment with the oral contraceptive containing drospirenone. The summary score of all subjects significantly decreased from 24,6 before they started using the oral contraceptive with drospirenone to 7,2 after 3 or 4 months of treatment with this oral contraceptive. Significant declines in summary scores have been shown in both groups (in the group without oral contraception from 24,9 at the start of the observation to 8,2 after 3 or 4 months of using this oral contraceptive with drospirenone; and from 24,3 to 6,0 in the group with the change from using various oral contraceptives to using the contraceptive containing drospirenone).

Conclusion:
The application of PSST for detection of severe premenstrual symptoms facilitates route – identification diagnosis of severe PMS/PMDD in practice and also allows the evaluation of treatment. Both in the group of women without oral contraceptive at the start of the evaluation and in the group of women who changed to the oral contraceptive, symptoms significantly decreased after 3 or 4 months of treatment with the oral contraceptive containing drospirenone and severe PMS and PMDD was practically eliminated. In the case of diagnosis of severe PMS/PMDD in women wishing to use an oral contraceptive, it is important to start treatment with the oral contraceptive containing drospirenone and for women with severe PMS/PMDD symptoms when using different oral contraceptives, it is important to change to the contraception with drospirenone.

Key words:
premenstrual syndrome, premenstrual dysphoric disorder, The Premenstrual Symptoms Screening Tool, oral contraceptive containing drospirenone.

Zdroje

1. Borenstein, J., Dean, B., Endicott, J., et al. Health and economic impact of the premenstrual syndrome. J Reprod Med, 2003, 48, p. 515-524.

2. Indusekhar, R., O;Brien, PMS. International consensus on the definition and diagnosis of premenstrual syndome and premenstrual dysphoric disorder. Gynaecology Forum, 2008 13, 3, p.5-7.

3. Steiner, M., Macdougall, M., Brown, E. The premenstrual symptoms screening tool (PSST) for clinicians. Arch Womens Ment Health, 2003, 6, p. 203-209.

4. Endicott, J., Nee, J., Harrison, W. Daily record of severity of problems (DRSP):reliability and validity. Arch Womens Ment Health, 2006, 9, p. 41-49.

5. Svojanovská, K., Herman, E. Současné možnosti diagnostiky a léčby závažného PMS/PMDD v gynekologické praxi: Mod Gynek Porod, 2009, 18 (suppl. A), 4, p. 608-619.

6. Genazzani, AR., Monteleone, P., Simi, G. Theories surrounding the aetiology of premenstrual syndrome and premenstrual dysphoric disorder. Gyneacol Forum, 2008, 13, 3, p. 8-12.

7. Cunningham, J.,Yonkers, KA., et al. Update on research and treatment of premenstrual dysphoric disorder. Harv Rev Psychiatry, 2009, 17, 2, p. 120-132.

8. Panay, S., Studd, JWW. The management of PMS/PMDD through ovarian cycle supression. In: The premenstrual syndromes: PMS and PMDD. Informa Healthcare, 2007.

9. Yonkers, KA., Brown, C., Pearlstein, TB., et al. Efficacy of a new low-dose oral contraceptive with drospirenone in premenstrual dysphoric disorder. Obstet Gynecol, 2005, 106, p. 492-501.

10. Pearlstein, TB., Bachmann, GA., Zacur, HA., et al. Treatment of premenstrual dysphoric disorder with a new drospirenon-containing oral contraceptive formulation. Contraception, 2005, 72, p. 414-421.

11. Lopez, LM., Kaptein, A., Helmerhorst, FM. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev 2008, 1: CD006586.

12. Bancroft, J., Rennie, D. The impact of oral contraceptives on the experience of perimenstrual mood, clumsiness, food craving and other symptoms. J Psychosom Res, 1993, 37, p. 195-202.

13. Andersch, B. The effect of various oral contraceptive combinations on premenstrual symptoms. Int J Gynecol Obstet, 1982, 20, p. 463-469.

14. Backstrom, T., Hansson-Malmstrom, Y., Lindhe, BA., et al. Oral contraceptives in premenstrual syndrome: a randomized comparison of triphasic and monophasic preparations. Contraception, 1992, 46, p. 253-268.

15. Graham, CA., Sherwin, BB. A prospective treatment study of premenstrual symptoms using a triphasic oral contraceptive. J Psychosom Res, 1992, 36, p. 257-266.

16. Boschitsch, E. Women’s well-being: the noncontraceptive benefits of Yasmin. Gyneacology Forum, 2002, 7, p. 23.

17. Brown, C., Ling, F., Wan, J. A new monophasic oral contraceptive containing drospirenone: effect on perimenstrual symptoms. J Reprod Med, 2002, 47, p. 124.

18. Freeman, EW., Kroll, R., et al. Evaluation of a unique oral contraceptive in treatment of premenstrual dysphoric disorder. J Women@s Health Gend Based Med, 2001, 10, p. 561.

19. Borenstein, J., Yu, HT., et al. Effect of an oral contraceptive containing ethinyl estradiol and drospirenone on premenstrual symptomatology and health-related quality of life. J Reprod Med, 2003, 48, p. 79.

20. Apter, D., Borsos, A., et al. Effect of an oral contraceptive containing drospirenone and ethinylestradiol on general well-being and fluid-related symptoms. Eur J Contracept Reprod Health Care, 2003, 8, p. 37.

21. Boschitsch, E., Skarabis, H., et al. The acceptability of novel oral contraceptive containing drospirenone and its effect on well-being. Eur J Contracept Reprod Health Care, 2000, 5 (suppl. 3), p. 34.