Combined oral contraceptives for premenstrual syndrome
Treatment of PMS or PMDD with a combined oral contraceptive (COC) aims to suppress ovulation, which may reduce symptoms. Progestogens used alone are ineffective and may even aggravate symptoms.
In a study of placebo versus a COC containing 20 micrograms of ethinylestradiol plus drospirenone, patients treated with the COC experienced less disruption of social activities, and improved productivity and relationships1. Other monophasic oral contraceptives are also appropriate for PMS and PMDD. Consider using a shorter hormone-free interval. Extended or continuous use may benefit mood symptoms more than cyclical use.
For a COC to treat PMS or PMDD, use:
combined oral contraceptive
(monophasic) orally, once daily (see Formulations of combined hormonal contraception available in Australia for formulations). Advise extended or continuous use to avoid or minimise withdrawal bleeding and other menstrual or premenstrual symptoms.
premenstrual syndrome and premenstrual dysphoric disorder
1 Pearlstein TB, Bachmann GA, Zacur HA, Yonkers KA. Treatment of premenstrual dysphoric disorder with a new drospirenone-containing oral contraceptive formulation. Contraception 2005;72(6):414-21. [URL];Yonkers KA, Brown C, Pearlstein TB, Foegh M, Sampson-Landers C, Rapkin A. Efficacy of a new low-dose oral contraceptive with drospirenone in premenstrual dysphoric disorder. Obstet Gynecol 2005;106(3):492-501. [URL]
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