Trial to test low dose oral contraceptives to ease PMDD symptoms

Washington, Aug 19 : A new clinical trial using a low-dose contraceptive may identify a more effective treatment for five to 10 percent of women who suffer from premenstrual dysphoric disorder.

The disorder, PMDD, is much more severe than premenstrual syndrome, or PMS. It curtails a woman's ability to function effectively several days a month.

Symptoms include bloating, low energy, palpitations and joint or muscle pain. Far more disruptive emotional symptoms include irritability, anxiety, depression, mood swings, difficulty focusing and trouble sleeping.

For many women with PMDD, five or more of these symptoms occur the week before menstruation starts and disappear a few days after the period begins.

The National Institute of Mental Health awarded University of North Carolina (UNC) a $3 million grant for a five-year clinical trial using a low-dose contraceptive called YAZ (ethinyl estradiol/drospirenone).

The trial is based on previous research by David Rubinow, who holds the chair of psychiatry in the UNC School of Medicine.

Rubinow said women with the disorder don't have abnormal levels of reproductive hormones, but are more sensitive to the shifts in them that occur prior to menstruation. That sensitivity triggers mood symptoms.

His colleague and fellow investigator Susan Girdler, professor of psychiatry, added "if we can eliminate the hormone cycling, we should eliminate the PMDD symptoms."

During the trial, researchers will test three groups of 27 women for a three-month period. One group will take a full 28-day dose of oral contraceptives continuously, while another takes the standard 21-7 regimen each month. A third group will be given a placebo.

After the three months, researchers will measure hormone cycling, as well as metabolites of progesterone, which are involved in activating brain centres. "They're regulators of mood and emotion, so if you can eliminate the metabolites that have been implicated in PMDD you may create a huge benefit for women with PMDD," Girdler said.

--IANS