EFFICACY OF PROGESTERONE VAGINAL SUPPOSITORIES IN ALLEVIATION OF NERVOUS SYMPTOMS IN PATIENTS WITH PREMENSTRUAL-SYNDROME

Purpose: To fur ther investigate the efficacy of progesterone in the t reatment of the symptoms of premenstrual syndrome (PMS). Materials and Methods: From an initial cohort of 25 subjects diagnosed with moderat e to severe PMS, 17 reproductive age females completed the 7-month, do uble-blind, placebo controlled trial rising 200-mg vaginal progestone suppositories. Multiple modalities for evaluating symptoms were employ ed, including the Spielberger self-evaluation rating, the Beck depress ion inventory, and the Hamilton anxiety scale. In addition, each subje ct was interviewed by a psychiatrist on a monthly basis; ovulation was determined monthly using a basal body temperature chart; serum hormon al assays included beta endorphin, progester one, follicle stimulating hormone, luteinizing hormone, estradiol, and prolactin. Results: Horm onal assays confirmed no differences between treatment and control gro ups. Overall scores on all test vehicles were likewise not significant ly different between the two groups; however, in the subcategory of ne rvous symptoms, a significant improvement was found in symptoms relati ng to tension, mood swings, irritability, anxiety and lack of control. Conclusions: Metabolites of progesterone (pregnanolone and allopregna nolone) may play a physiologic role as anxiolytic agents, perhaps modi fying mood and anxiety; the current study confirms the utility of twic e daily, 200-mg progester one vaginal suppositories, in the alleviatio n of some PMS symptoms relating to anxiety and irritability. Further e valuation may be warranted to ascertain which patients in the known he terogeneous PMS population may be most likely to benefit from such tre atment.