Non-randomised trial, 1991
Do PMS symptoms depend on the luteal phase of the cycle?
No. PMS symptoms did not improve when the luteal phase was artificially ended, suggesting that the luteal phase itself may not directly cause PMS.
What they did
Researchers studied 14 women with PMS and gave them mifepristone (a drug blocking progesterone) at 12.5 or 25 mg per kilogram of body weight on day 7 after ovulation. Some also received a hormone to extend progesterone levels. A separate group of 7 women with PMS received placebo. All women filled out daily questionnaires about mood and body symptoms.
What they found
Mifepristone successfully triggered menstruation and lowered progesterone to follicular phase levels (less than 3 nmol per liter) within 4 days. Despite this, symptom severity was significantly higher after treatment than before in all groups. The level and pattern of symptoms were similar across all groups.
What it means for you
PMS symptoms did not improve when the late luteal phase was ended, which suggests something other than just the luteal phase directly causes PMS. This challenges the idea that PMS is simply a response to progesterone in the second half of the cycle. Main limits: small sample (14 women), only one cycle tested, and the study was not fully randomised.
14
women receiving mifepristone
<3 nmol/L
progesterone after treatment
4 days
time to reach follicular progesterone level
About the study
- Original title
- Lack of effect of induced menses on symptoms in women with premenstrual syndrome
- Authors
- Schmidt PJ, Nieman LK, Grover GN et al.
- Journal
- The New England journal of medicine
- Year
- 1991
- Study design
- Non-randomised trial
- What was tested
- Mifepristone 12.5 or 25 mg per kilogram of body weight, with or without hormone support
- Open access
- Yes
- Read the paper
- doi.org/10.1056/nejm199104253241705