How to treat PMDD (premenstrual dysphoric disorder)? Danazol (Danocrine), Antidepressants, Oral contraceptives.
The PMDD symptoms are successfully obviated by several medical therapies described below.
Several medicines from the group of selective serotonin reuptake inhibitors (SSRIs) are successfully used to relief the symptoms of PMDD by removing their reason. These medications influence on human organism by influencing on the level of serotonin in the brain.
SSRIs whose effectiveness has been proved include the following drugs:
- sertraline (Zoloft)
- paroxetine (Paxil)
- citalopram (Celexa)
SSRI medicines are reported to be very effective therapy, as about 75% of women who used SSRIs felt significant alleviation of symptoms. Side effects, such as nausea, headaches and uneasiness are experienced by 15% of women who take SSRIs. As a rule SSRI drugs are prescribed for continuous intake or taking only during 14-days of the luteal phase. Other groups of antidepressants, as well as lithium medicines (like Lithobid) haven’t shown their effectiveness in PMDD prevention therapy.
Oral contraceptives and GnRH agonists
Other ways of PMDD treatment are avoidance of ovulation and ovarian hormones control. For this purpose oral contraceptives are used. OCPs, birth control pills change the menstrual cycle by inhibiting the ovulation process.
Gonadotropin-releasing hormone analogs (GnRH analogs or GnRH agonists) influence on hormones production and are widely used in anti-PMDD therapy. Suppressing estrogen production by influencing on pituitary gland as inhibitor of regularly hormones secretion causes the stoppage of menstrual periods. GnRH agonists are used in one of two available forms – injection or nasal.
GnRH agonists used in PMDD treatment include:
- leuprolide (Lupron)
- goserelin (Zoladex) and
- nafarelin (Synarel)
There are a whole variety of side effects caused by GnRH agonist medicines: vaginal dryness, occasional bleedings, mood swings, tiredness, hot flashes and osteoporosis (the loss of bone strength). These side effects are caused by the shortage of female hormones and can be minimized by additional intake of estrogen and progesterone.
This synthetic medicine influences on hormone balance, increasing the content of androgen (male hormone) and decreasing estrogen content in the organism. Such hormonal environment suppresses ovulation and inhibits ovarian estrogen production. Danazol is effectively used to prevent PMDD symptoms, but in 75% of cases the treatment is accompanied with various side effects including:
- Weight growth,
- breast size decreasing,
- male-like hair growth
- voice mutation (deeping),
- acne and oily skin,
- libido changes,
- mood swings.
These side effects except voice mutations are convertible. But returning to the normal state can take months or even years. That is why Danazol (Danocrine) is used only when other medications are helpless. The intake of these drugs is forbidden for women with certain liver, kidneys and heart disorders.
Alternative therapy of PMDD include chasteberry extract (agnus castus fruit), special diets with additional intake of calcium, B6 and E vitamins. These therapies have shown their effectiveness in relieving the PMS/PMDD symptoms.