Potential strategies to avoid progestogen-induced premenstrual disorders
| Autor: | Lucy J Baker, P M S O'Brien |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Hormone Replacement Therapy medicine.medical_treatment media_common.quotation_subject Endometriosis Hysterectomy Contraceptives Oral Hormonal Gonadotropin-Releasing Hormone Premenstrual Syndrome medicine Endocrine system Humans Intensive care medicine Ovulation reproductive and urinary physiology Menstrual cycle Menstrual Cycle media_common Gynecology Progestogen Dose-Response Relationship Drug business.industry Hormone replacement therapy (menopause) Estrogens Progestogen-only contraception medicine.disease female genital diseases and pregnancy complications Estrogen Female Progestins business hormones hormone substitutes and hormone antagonists Selective Serotonin Reuptake Inhibitors |
| Zdroj: | Menopause international. 18(2) |
| ISSN: | 1754-0461 |
| Popis: | Non-hormonal approaches to premenstrual syndrome (PMS) treatment such as selective serotonin reuptake inhibitors are by no means effective for all women and frequently we must resort to endocrine therapy. During many of the hormonal approaches, PMS-like symptoms can be introduced or re-introduced during the necessary cyclical or continuous progestogen component of the therapy. This is seen with combined oral contraception, progestogen only contraception, progestogen therapy for heavy menstrual bleeding and endometriosis, sequential hormone replacement therapy and any therapeutic strategy for premenstrual syndrome where it is necessary to provide endometrial protection, including estrogen suppression of ovulation or add-back during gonadotrophin releasing hormone suppression. The link to progestogen is very often missed by health professionals. When the pattern of symptoms mimics the cyclicity of PMS, it is termed progestogen-induced premenstrual disorder. The need to use progestogen to protect the endometrium from the proliferative actions of estrogen can pose insurmountable difficulties in managing premenstrual disorders. In the absence of any really useful evidence, nearly all practice in this area depends on clinician experience. We cannot afford to wait for adequate research evidence to be produced – it never will – and so we must rely on empirical findings, clinical experience, theoretical strategies and common sense. |
| Databáze: | OpenAIRE |
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