OVARIAN SUPPRESSION WITH THE GONADOTROPIN-RELEASING-HORMONE AGONIST GOSERELIN (ZOLADEX) IN MANAGEMENT OF THE PREMENSTRUAL TENSION SYNDROME

The objective of this study was to determine the effectiveness of ovar ian suppression by a GnRH agonist analogue in 32 women with prospectiv ely confirmed severe premenstrual tension. The design was a randomized , double-blind study comparing goserelin 3.6 mg with placebo, both giv en as a monthly s.c. injection for 3 months. Self-assessment was by da ily visual analogue scales (VAS) for anxiety and depression, daily qua ntitative symptom rating for breast discomfort, swelling, irritability , tension, depression and by monthly Hospital Anxiety and Depression ( HAD) scales. Of the 16 women in each group, 15 completed active and 12 completed placebo therapy. Median symptom scores for whole cycles sho wed a significant reduction of breast discomfort and swelling during a ctive treatment, with no significant improvement in psychological symp toms. Analysis by cycle phase showed that for individual subjects, pre -treatment differences in VAS scores for anxiety and depression were a bolished in a significantly greater proportion of actively treated cyc les. Within-group comparisons showed a marked placebo effect and, comp aring the two groups, differences reached significance only during tre atment cycle 1 and the first posttreatment cycle for anxiety with no s ignificant differences for depression. It was concluded that while sup pression of ovarian activity with a gonadotrophin-releasing hormone an alogue dampens down cyclical mood swings, it has a more marked effect on the physical components of the premenstrual syndrome. Results recon firm the positive role of placebo in the management of this condition.