Premenstrual syndrome: opportunities for a differentiated approach to treatment
Objective. To comparatively study the efficiency and acceptability of phyto- and hormone therapy in the treatment of women with moderate and severe PMS.Ledina A.V., Prilepskaya V.N.
Material and methods. The study included 243 patients aged 16–49 years with moderate or severe PMS; 121 women were treated with dry Vitex agnus castus fruit extract (4 mg); 122 women received an oral contraceptivecontaining 20 mg of ethinyl estradiol and 3 mg of drospirenone in a 24/4 regimen. The severity of PMS and the efficiency of treatment were evaluated by analyzing the questionnaires, PMS diaries, and visual analog scale, which had been filled out by the patients.
Result. The evaluation of the impact of therapy on the course of PMS showed that the phytopreparation was more highly effective against the metabolic and endocrine manifestations of PMS, to a greater extent the dietary behavior of patients, and mastalgia. There were more pronounced psychoemotional changes during hormone treatment.
Conclusion. Phytopreparation containing 4 mg of dry extract Vitex agnus castus was effective in treating women with moderate or severe PMS. The proportion of women who have improved after 6 cycles of treatment, calculated on the basis of the self-assessment scale of the questionnaire, was 66.1%. This is comparable to the effectiveness of a hormonal combined contraceptive preparation containing 20 μg of ethinyl estradiol and 3 mg of drospirenone 24/4 in the treatment of PMS (the proportion of women – 71.3%, p < 0.05).
Keywords
premenstrual syndrome
treatment
questioning
phytotherapy
dry Vitex agnus castus fruit extract
drospirenone-containing combined oral contraceptives
References
1. O’Brien P.M., Bäckström T., Brown C., Dennerstein L., Endicott J., Epperson C.N. et al. Towards a consensus on diagnostic criteria, measurement and trial design of the premenstrual disorders: the ISPMD Montreal consensus. Arch. Womens Ment. Health. 2011; 14(1): 13-21.
2. Mishell D.R. Jr. Premenstrual disorders: epidemiology and disease burden. Am. J. Manag. Care. 2005; 16(11): 473-9.
3. Tschudin S., Bertea P.C., Zemp E. Prevalence and predictors of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample. Arch. Womens Ment. Health. 2010; 13(6): 485-94.
4. Dueñas J.L., Lete I., Bermejo R., Arbat A., Pérez-Campos E., Martínez-Salmeán J. et al. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in a representative cohort of Spanish women of fertile age. Eur. J. Obstet. Gynecol. Reprod. Biol. 2011; 156(1): 72-7.
5. Ледина А.В., Акимкин В.Г., Прилепская В.Н. Предменструальный синдром: распространенность и основные проявления (результаты эпидемиологического исследования). Эпидемиология и вакцинопрофилактика. 2014; 2: 66-71.
6. Whelan A.M., Jurgens T.M., Naylor H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can. J. Clin. Pharmacol. 2009; 16(3): 407-29.
7. Imai A., Ichigo S., Matsunami K., Takagi H. Premenstrual syndrome: management and pathophysiology. Clin. Exp. Obstet. Gynecol. 2015; 42(2): 123-8.
8. Lopez L.M., Kaptein A.A., Helmerhorst F.M. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst. Rev. 2012; (2): CD006586.
9. van Die M.D., Burger H.G., Teede H.J., Bone K.M. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013; 79(7): 562-75.
10. Heskes A.M., Sundram T.C.M., Boughton B.A., Jensen N.B., Hansen N.L., Crocoll C. et al. Biosynthesis of bioactive diterpenoids in the medicinal plant Vitex agnus-castus. Plant J. 2018; 93(5): 943-58.
11. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Press; 1994.
12. Ледина А.В., Прилепская В.Н. Масталгия: клиника, диагностика, лечение. Гинекология. 2011; 13(5): 66-9.
13. Ismail M.S., Serour G.I., Torsten U., Weitzel H., Berlien H.P. Elevated serum prolactin level with high-dose estrogen contraceptive pills. Eur. J. Contracept. Reprod. Health Care. 1998; 3(1): 45-50.
14. Прилепская В.Н., Назарова Н.М. Эстроген-гестагенные рилизинг-системы. Акушерство и гинекология. 2007; 2: 24-27. [Prilepskaya V.N., Nazarova N.M. Estrogen-progestin releasing systems. Akusherstvo i ginekologiya/Obstetrics and gynecology (Moscow). 2007; 2: 24-27. (in Russian)]
Received 11.09.2018
Accepted 21.09.2018
About the Authors
Ledina, Antonina V., MD, Physician, Clinical Department «Lapino», Group of companies «Mother and Child» (143081, Moscow region, Odintsovo district, Lapino village, 1st Uspenskoe highway, 111); Associate Professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Improvement of Qualification of Medical Workers, Peoples’ Friendship University of Russia, Ministry of Education and Science of Russia;117198, Moscow, Miclucho-Maclay st, 6. Phone: +7 905 506 51 77, е-mail: antoninaledina@yandex.ru
Prilepskaya, Vera N., MD, professor, deputy director for scientific work, head of the scientific and polyclinic (out-patient department) of the FGBU “National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov “of the Ministry of Health of Russia Honored Scientist of the Russian Federation; 117513, Moscow, ul. Academician Oparin, 4. Tel. + 7-495-438-69-34; e-mail: vprilepskaya@mail.ru
For citations: Ledina A.V., Prilepskaya V.N. Premenstrual syndrome: opportunities for a differentiated approach to treatment Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (11): 92-7. (in Russian)
https://dx.doi.org/10.18565/aig.2018.11.92-97
Similar Articles
