Treatment of premenstrual dysphoric disorders with combined oral contraceptives

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) with severe psycho-emotional disorders. The frequency of occurrence of PMDD in women of the reproductive period of the Russian Federation is estimated at an average of 15.6 %. The development of PMDD is based on the individual sensitivity of neurotransmitters and neuropeptides to fluctuations in the levels of sex steroid hormones of the ovulatory menstrual cycle, therefore, hormone therapy drugs are used for PMDD therapy — combined oral contraceptives (COC) that suppress ovulation. The purpose of this study was to evaluate the effectiveness of COC containing drospirenone in the treatment of PMDD. Materials and methods. 78 women of the reproductive period underwent a comprehensive examination and treatment of PMDD symptoms with contraceptives containing 30 mg of ethinyl estradiol and 3 mg of drospirenone (Midian). Results of the study. The age of patients with PMDD averaged 33.7 years; 55 % of women were between 25–34 years old; 97 % needed contraception; all women represented in the group had higher education, normal menstrual function and body mass index. After 3 months of treatment, there was a statistically significant decrease in pain of various localization, problems with appetite, difficulties in communicating with others, sleep disturbances, and an increase in productivity at work, at home and in school. After 6 months of treatment, COC psycho-emotional symptoms, such as depression, anger, irritation, emotional lability, anxiety, tension, loss of control, significantly regressed, while the effectiveness of therapy reached 50 % relative to the original background. Physical symptoms of PMS, such as swelling of the mammary glands, pain of various locations, sleep disturbances, were stopped on average by 70 %. Conclusions. COC containing drospirenone can be used to treat severe premenstrual syndrome, i. e. PMDD.