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Premenstrual syndrome and spironolactone
R B Burnet1, H S Radden, E G Easterbrook
1Endocrine and Metabolic Unit, Royal Adelaide Hospital, South Australia.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|November 1, 1991
Summary
Spironolactone did not significantly improve Premenstrual Syndrome symptoms in a randomized trial. However, pre-treatment androgen level differences may predict patient response to spironolactone therapy.
Area of Science:
- Endocrinology
- Gynecology
- Pharmacology
Background:
- Premenstrual Syndrome (PMS) significantly impacts women's quality of life.
- Spironolactone, a diuretic, has been explored for potential PMS symptom relief.
- Predicting treatment response in PMS remains a clinical challenge.
Purpose of the Study:
- To evaluate the efficacy of spironolactone in managing Premenstrual Syndrome symptoms.
- To investigate the relationship between hormonal profiles and spironolactone response in PMS patients.
Main Methods:
- A double-blind, placebo-controlled, randomized cross-over study design.
- Daily self-assessment of somatic and neuropsychiatric symptoms for 14 days pre-menstrually.
- Hormonal assays including oestradiol, progesterone, prolactin, and androgens.
- Comparison of symptom scores and hormone levels on and off spironolactone.
Main Results:
- Spironolactone treatment showed no significant difference in overall PMS symptom scores compared to placebo.
- No significant changes in oestradiol, progesterone, or prolactin levels were observed.
- Patients who responded to spironolactone exhibited significant pre-treatment differences in androgen levels between the follicular and luteal phases.
Conclusions:
- Spironolactone is not effective in alleviating general Premenstrual Syndrome symptoms.
- Pre-treatment hormonal profiles, specifically phase-related androgen level variations, may identify patients likely to benefit from spironolactone therapy.