Citation

Robertson E, Thew C, Thomas N, Karimi L, Kulkarni J. Front. Endocrinol. (Lausanne) 2021; 12.

Copyright

(Copyright © 2021, Frontiers Research Foundation)

DOI

10.3389/fendo.2021.704488

PMID

unavailable

Abstract

BACKGROUND: Up to 80% of reproductive-aged women experience premenstrual symptoms. Premenstrual Dysphoric Disorder (PMDD) is a severe form, affecting 2-5% of women. Combined oral contraceptive pills (COCPs) are used in the treatment of PMDD. Clinical practice suggests that a newer COCP containing nomegestrol acetate (2.5mg) and 17-beta estradiol (1.5mg), may be a suitable treatment for mood symptoms in PMDD.

MATERIALS AND METHODS: This was a clinical follow-up feasibility study of women who had attended the Monash Alfred Psychiatry research centre, Women's Mental Health Clinic, with a diagnosis of PMDD. 67% of the sample also had concurrent cPTSD, 29% co-morbid anxiety, and 20% depression. They were recommended treatment with nomegestrol acetate/17-beta estradiol. Eligible women were contacted by telephone to answer a questionnaire to assess women's subjective response to nomegestrol acetate/17-beta estradiol, acceptability and the Depression, Anxiety and Stress Scale-21 (DASS-21) after being recommended nomegestrol acetate/17-beta estradiol. The paired-sample t-test was used to determine if there were any statistically significant differences in the DASS-21 scores over the study observation period (before and after taking nomegestrol acetate/17-beta estradiol).

RESULTS: 35 (74.5%) women reported a subjective positive mood response to nomegestrol acetate/17-beta estradiol, 31 (63.3%) adhered to the medication, and only 10 (20.4%) women reported side effects as the main reason for discontinuing nomegestrol acetate/17-beta estradiol. There were statistically significant reductions (p<0.05) in the overall DASS-21 scores from before women commenced nomegestrol acetate/17-beta estradiol and after commencement of treatment.

CONCLUSIONS: This preliminary study supports the acceptability and effectiveness of nomegestrol acetate/17-beta estradiol as a treatment for mood symptoms in PMDD. Further research, particularly a randomized controlled trial, is required to elucidate the effect of nomegestrol acetate/17-beta estradiol treatment on mood in PMDD. © Copyright © 2021 Robertson, Thew, Thomas, Karimi and Kulkarni.

Language: en

Keywords

adult; human; female; aged; pilot study; psychiatry; depression; anxiety; randomized controlled trial; suicide attempt; mood; acetic acid; posttraumatic stress disorder; pharmacist; progesterone; alcohol consumption; estradiol; major clinical study; mental disease; controlled study; questionnaire; anticonvulsive agent; antidepressant agent; neuroleptic agent; retrospective study; sexual behavior; smoking; prolactin; serotonin uptake inhibitor; validation process; middle aged; emotion; follow up; demography; benzodiazepine; sensitivity analysis; menstrual cycle; oral contraceptive agent; estrogen; Beck Anxiety Inventory; contraception; libido disorder; Article; premenstrual dysphoric disorder; feasibility study; metrorrhagia; drospirenone; levonorgestrel; menopausal syndrome; ethinylestradiol; clinical outcome; cognitive behavioral therapy; Likert scale; forced swim test; histogram; Depression, Anxiety and Stress Scale-21; nomegestrol acetate; nomegestrol acetate/17-beta estradiol