RESULTS OF THE CLINICAL USE OF A DROSPIRENONE-CONTAINING AGENT IN WOMEN WITH SEVERE PREMENSTRUAL SYNDROME

Objective. To evaluate the therapeutic efficacy and acceptability of a low-dose combined oral contraceptive (COC) containing the spironolactone derivative drospirenone as a gestagenic component in the management of patients with premenstrual dysphoric disorder (PMDD). Subjects and methods. Thirty-nine women (mean age 29.95±1.66 years) diagnosed as having PMDD established in accordance with the generally accepted standards (DSM-IV) were followed up. Physical examination, clinical, laboratory, and instrumental studies, as well as consultations by a psychologist and a psychiatrist were performed. The low-dose COC midiana containing 30 μg ethinyl estradiol and 3 mg drospirenone was used as a 21+7 regimen in all the patients. The therapeutic efficacy of the contraceptive on the course of PMDD was evaluated using premenstrual syndrome questionnaires and diaries, as well as psychological scales for anxiety and depression and the types of psychological protection. Results. The most common psychoemotional symptoms were irritability (97.4%), nutritional behavioral impairment (89.7%), depression (84.6%), tearfulness (71.83 %), and aggressivity (66.7%); the most frequent somatic symptoms were mastodynia and mastalgia (94.9%), abdominal distention (92.3%), lower abdominal pain (82.1%), edemas (74.4%), and headache (64.1%). When used, the COC showed a high therapeutic effect in women with PMDD: following 6 months, irritability and mastodynia were observed in 24 (61.5%) and 11 (28.2%), respectively. The patients had affective improvement according to the psychological scales and questionnaires over time, by applying score rating scales. Within the first month of COC use, an inconsiderable number of women had adverse reactions: all symptoms disappeared spontaneously and did not require additional contraception or its discontinuation. The contraceptive efficiency was 100%. Conclusion. The low-dose COC containing drospirenone, 3 mg, and ethinyl estradiol, 30 μg, as a gestagenic component has a high contraceptive efficiency and does not cause significant side effects. The contraceptive favorably affects the symptoms of PMDD, by lowering their degree by an average of 40%.

premenstrual syndrome, premenstrual dysphoric disorder, contraception