GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum27681ArticlesСтатьиResearch ArticleGormonal'nye metody terapii predmenstrual'nogo sindromaГормональные методы терапии предменструального синдромаTarasovaM AТарасоваМ АLekarevaT MЛекареваТ МГУ НИИ акушерства и гинекологии им. Д.О.Отта РАМН, Санкт-Петербург1508200574VOL 7, NO4 (2005)ТОМ 7, №4 (2005)21421909042020Copyright ©; 2005, Consilium MedicumCopyright ©; 2005, ООО "Консилиум Медикум"2005Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/27681

Предменструальный синдром (ПМС) – симптомокомплекс, возникающий в дни, предшествующие менструации, и проявляющийся нервно-психическими, вегетативно-сосудистыми и обменно-эндокринными нарушениями [1]. Несмотря на его широкую распространенность в популяции, до настоящего времени не выработано единой стратегии лечения пациенток с ПМС. Учитывая цикличность течения и предположение о ведущей роли гормональных изменений в патогенезе ПМС, для его терапии используются различные гормональные средства, эффективность которых проанализирована в данном обзоре.

предменструальный синдромгормональная терапиякомбинированные оральные контрацептивыМежевитинова Е.А., Прилепская В.Н. Предменструальный синдром. Гинекология. 2002; приложение: 3–8.Merikangas K.R, Foeldenyi M, Angst J. The Zurich Study. XIX. Patterns of menstrual disturbances in the community:results of the Zurich Cohort Study. Eur Arch Pdychiatry Clin Neurosci 1993; 243: 23–32.Stewart A. A rational approach to treating the premenstrual syndrome. Seal, Kent: National Association of Premenstrual Syndrome, 1989.Wyatt K, Dimmock P, Jones P et al. Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review. BMJ 2001; 323: 1–8.Van der Meer, Benedek-Jazmann L.J, Van Loenen A.C. Efect of high - dose progesterone on the premenstrual syndrome; a double - blind crossover trial. J Psychosom Obstet Gynaecol 1983; 2: 220–2.Freeman E.W, Rickels K, Sondheimer S.J, Polansky M. A double - blind trial of oral progesterone, alprazolam, and placebo in treatment of severe premenstrual syndrome. JAMA 1995; 274: 51–7.Dennerstein L, Spencer-Gardner C, Gotts G et al. Progesterone and the premenstrual syndrome: a double - blind crossover trial. BMJ 1985; 290: 1617–21.Vanselow W, Dennerstein L, Greenwood K.M, de Lignieres B. Effect of progesterone о and its 5 alpha and 5 beta metabolites on symptoms of premenstrual syndrome according to route of administration. J Psychosom Obstet Gynaecol 1996; 17: 29–38.Maxson W.S. The use of progesterone in the treatment of premenstrual syndrome. Clin Obstet Gynecol 1987; 30: 465–77.West С.Р. Inhibition of ovulation with oral progestins – effectiveness in premenstrual syndrome. Eur J Obstet Gynecol Reprod Biol 1990; 34: 19–28.Dennerstein L, Morse C, Gotts G et al. Treatment of premenstrual syndrome. A double - blind trial or dydrogesterone. J Affect Disord 1986; 11: 199–205.Williams J.G.C, Martin A.J, Hulkenberg-Tromp A. Premenstrual syndrome in four European countries. Part. A double - blind controlled study of dydrogesterone. Br J Sexual Med 1983; 10: 8–18.Andersch B, Hahn L. Progesterone treatment of premenstrual tension – a double - blind study. J Psychosom Res 1985; 29: 489–93.Maddocks S, Hahn P, Moller F, Reid R.L. A double - blind placebo - controlled trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome. Am J Obstet Gynecol 1986; 154: 573–81.Rapkin A.J, Chang L.H, Reading A.E. Premenstrual syndrome; a double - blind placebo - controlled study of treatment with progesterone vaginal suppositories. J Obstet Gynecol 1987; 7: 217–20.Corney R.H, Stanton R, Newell R. Comparison of progesterone, placebo and behavioural psychotherapy in the treatment of premenstrual syndrome. J Psychosom Obstet Gynaecol 1990; 11: 211–20.Freeman E.W, Rickels K, Sondheimer S.J, Polansky M. Ineffectiveness of progesterone suppository treatment for premenstrual syndrome. JAMA 1990; 264: 349–53.Magill P.J. Investigation of the efficacy of progesterone pessaries in the relief of symptoms of premenstrual syndrome. Progesterone study Group. Br J Gen Pract 1995; 45: 589–93.Watson N.R, Studd J.W, Savvas M et al. Treatment of severe premenstrual syndrome with oestradiol patches and cyclical oral norethisterone. Lancet 1989; 2: 730–2.Dhar V, Murphy B.E. Double - blind randomized crossover trial of luteal phase estrogens (Premarin) in the premenstrual syndrome. Psychoneuroendocrinology 1990; 15: 489–93.De Lignieres B, Vincens M, Mauvais-Jarvis P, Mas J.L, Touboul P.J, Bousser M.G. Prevention of menstrual migraine by percutaneous oestradiol. BMJ 1986; 293: 1540.Kouri E.M, Halbreich U, Hormonal treatments for premenstrual syndrome. Drugs today (Barc). 1998 Jul; 34 (7): 603–10.Derzko C.M. Role of danazol in relieving the premenstrual syndrome. J Reprod Med 1990 Jan; 35 (1 Suppl.): 97–102.Hahn P.M, van Vugt D.A, Reid R.L. A randomized, placebo - controlled, crossover trial of danazol for the treatment of premenstrual syndrome. Psychoneuroendocrinology. 1995; 20 (2): 193–209.Halbreich U, Rojansky N, Palter S. Elimination of ovulation and menstrual cyclicity (with danazol) improves dysphoric premenstrual syndromes. Fertil Steril. 1991 Dec; 56 (6): 1066–9.Watts J.F, Butt W.R, Logan E.R. A clinical trial using danazol for the treatment of premenstrual tension. Br J Obstet Gynaecol 1987; 94: 30–4.Sarno A.P.J, Miller E.J.J, Lundblad E.G. Premenstrual syndrome: beneficial effects of periodic, low - dose danazol. Obstet Gynecol 1987; 70: 33–6.O'Brian P.M.S, Abukhalil I.E.H. Randomized controlled trial of the management of premenstrual syndrome and premenstrual mastalgia using luteal phase only danazol. An J Obstet Gynecol 1999; 180: 18–23.Sundstrom I, Nyberg S, Bixo M et al. Treatment of premenstrual syndrome with gonadotropin - releasing hormone agonist in a low dose regimen. Acta Obstet Gynecol Scand 1999 Nov; 78 (10): 891–9.Freeman E.W, Sondheimer S.J, Rickels K. Gonadotropin - releasing hormone agonists in the treatment of premenstrual symptoms with and without ongoing dysphoria: a controlled study. Psychopharmacol Bull 1997; 33 (2): 303–9.Studd J, Leather A.T. The need for add - back with gonadotrophin - releasing hormone agonist therapy. Br J Obstet Gynaecol 1996 Oct; 103 (Suppl. 14): 1–4.Mortola J.F. From GnRH to SSRIs ana Beyond: Weighing the Options for Drug Therapy in Premenstrual Syndrome. Medscape Womens health. 1997 Oct; 2 (10): 3.Halbreich U. Treatment of premenstrual syndromes with progesterone antagonists (e.g.,RU-486): political and methodological issues. Psychiatry 1990 Nov; 53 (4): 407–9.Chan A.F, Mortola J.F, Wood S.H, Yen S.S. Persistence of premenstrual syndrome during low - dose administration of the progesterone antagonist RU 486. Obstet Gynecol 1994 Dec; 84 (6): 10001–5.Srbmidt P.J, Neiman L.K, Grover G.N et al. Lack of effect of induced mences on symptoms in women with premenstrual syndrome. N Engl J Med 1991 Apr 25; 324 (17): 1174–9.Graham С A, Sherwin B.B. Tne relationship between retrospective С A, Sherwin B.B. Tne relationship between retrospective premenstrual syndrome reporting and present oral contraceptive use. J Psychosom Res 1987; 31: 45–53.Backstrom T, Hanason-Malmstrom Y, Lindhe B.A et al. Oral contraceptives in premenstrual syndrome: A randomized comparison of triphasic and monophasic preparations. Contraception 1992; 46: 253–68.Abraham S, Luscombe G, Soo I. Oral contraception and cyclic changes in premenstrual and menstrual experiences. J Psychosom Obstet Gynaecol 2003 Sep; 24 (3): 185–9.Bancroft J, Rennie D. The impact of oral contraceptives on the experience of perimenstrual mood, clumsiness, food craving and other symptoms. J Psychosom Res 1993; 37: 195–202.Hallman J. The premenstrual syndrome – an equivalent of depression. Acta Psychiatr Scand 1986 Apr; 73 (4): 403–11.Winkler U.H, Ferguson H, Mulders J.A. Cycle control, quality of life and acne with two low - dose oral contraceptives containing 20 micro gram ethinylestradiol. Contraception 2004 Jun; 69 (6): 469–76.Williams C.L, Stancel G.M. Estrogens and progestins. In Goodman and Gilman's Pharmacological Basis of Therapeutics. Ninth edition. Edited by J.G Hardman, L.E Limbird, P.B Molinoff et al. New York, Mc Graw-Hill, 1996; 1411–37.Huber J, Foidart J.M, Wuttke W. Efficacy and tolerability of a monophasic oral contraceptive containing ethynilestradiol and drospirenone. Eur J Contracept reprod Health Care 2000; 5: 25–34.Losert W, Casals-Stenzel J, Buse M. Progestogens with antimineralcorticoid activity. Arzneimittelforschung 1985; 35: 459–71.Muhn P, Fuhrmann U, Fritzemeier K.H et al. Drospirenone: a novel progestogen with antimineralcorticoid and antiandrigenic activity. Ann N Y Acad Sci 1995; 761: 311–35.Oelkers W, Helmerhorst F.M, Wuttke W et al. Effect of an oral contraceptive containing drospirenone on the rennin - angiotensin - aldosterone system in healthy female volunteers. Gynecol Endocrinol 2000; 14: 204–13.Oelkers W, Foidart J.M, Dombrovicz et al. Effects of a new oral contraceptive containing an antimineralcorticoid progestogen, drospirenone, on the rennin - aldosterone system, body weight, blood pressure, glucose tolerance, and lipid metabolism. J Clin Endorinol Metab 1995; 80: 1816–21.Losert W, Casals-Stenzel J, Buse M. Progestogens with antimineralcorticoid activity. Arzneimittelforschung 1985; 35: 459–71.Foidart J.M, Wuttke W, Bouw G.M et al. A comparative investigation of contraceptive reliability, cycle control and tolerance of two monophasic oral contraceptives containing either drospirenone or desogestrel. Eur J Contracept Reprod Health Care 2000; 5: 124–34.Oelkers W, Foidart J.M, Dombrovicz et al. Effects of a new oral contraceptive containing an antimineralcorticoid progestogen, drospirenone, on the rennin - aldosterone system, body weight, blood pressure, glucose tolerance, and lipid metabolism. J Clin Endorinol Metab 1995; 80: 1816–21.Fuhrmann U, Krattenmacher R, Slater E.P et al. The novel progestin drospirenone and its natural counterpart progesterone: biochemical profile and antiandrogenic potential. Contraception 1996; 54: 243–51.Mansour D Experiences with Yasmin: the acceptability of a novel oral contraceptive andits effect on well - being. Eur J Contracept reprod Health Care. 2002 Dec; 7 (Suppl. 3): 35–41.Apter D, Borsos A, Baumgartner W et al. Effect of an oral contraceptive containing drospirenone and ethinylestradiol on general well - being and fluid - related symptoms.Wiklund I, Dimenas E, Wahl M. Factors of importance when evaluating quality of life in clinical trials. Control Clin Trials 1990; 11: 169–79.Borenstein J, Yu H.T, Wade S et al. Effect of an oral contraceptive containing ethinyl estradiol and drospirenone on premenstrual symptomatology and health - related quality of life. J Reprod Med 2003 Feb; 48 (2): 79–85.Boschitch E, Skarabis H, Wuttke W et al. The acceptability of a novel oral contraceptive containing drospirenone and its effect on well - being. The Eur J of Contracept and Reprod Health Care 2000; 5 (suppl. 3): 34–40.Brown C, Ling F, Wan J. A new monophasic oral contraceptive containing drospirenone. Effect on premenstrual symptoms. J Reprod Med 2002 Jan; 47 (l): 14–22.Freeman E.W, Kroll R, Rapkin A et al. PMS/PMDD Research Group. Evaluation of a unique oral contraceptive in the treatment of premenstrual dysphoric disorder. J Womens Health Gend Based Med 2001 Jul-Aug; 10 (6): 561–9.Freeman E.W. Evaluation of a unique oral contraceptive (Yasmin) in the management of premenstrual dysphoric disorder. Eur J Contracept Reprod Health Care 2002 Dec; 7 (Suppl): 27–34; discussion 42–3.Grimes D.A et al. Supression of menstruation with extended ОС regimens. The Contraception Report 2002; 13 (3): 8–11.Sulak P, Scow R.D, Preece C et al. Hormone withdrawal symptoms in oral contraceptive users. Obstet Gynecol 2000; 95: 261–6.Loudon N.B, Foxwell M, Potts D.M et al. Acceptability of an oral contraceptive that reduces the frequency: The tri - cycle pill regimen. BMJ 1977; 2: 487–90.Couthino E.M, Segal S.J. Is menstruation Obsolete? New York: Oxford University Press, 1999.Kaunitz A.M. Menstruation: choosing whether..and when. Contraception 2000; 62: 277–84.Nelson A.L. Whoose pill is it, anyway? Fam Plann Perspect 2000; 32: 89–90.Clarke A.K, Miller S.J. The debate regarding continuous use of oral contraceptives. Ann Pharmacother 2001; 35: 1480–4.Schwartz J.L, Creinin M.D, Pymar H.C. The trimonthly combination oral contraceptive regimen: Is it cost effective? Contraception 1999; 60: 263–7.Sulak P.J, Kuehl T.J, Ortiz M.J, Shul B.L. Acceptance of altering the standard 21-day/7-day oral contraceptive regimen to delay menses and reduce hormone withdrawal symptoms. Am J Obstet Gynecol 2002; 186,6: 1142–49.Schilling L.H, Bolding О.Т, Chenault C.B et al. Evaluation of the clinical performance of three triphasic oral contraceptives: A mufti - center, randomized comparative trial. Am J Obstet Gynecol 1989; 160: 1264–8.Rosenberg M.J, Meyers A, Roy V. Efficacy, cycle control, and side effects of low and lower dose oral contraceptives: A randomized trial of 20 micrograms and 35 micrograms estrogen preparations. Contraception 1999; 60: 321–9.Miller L, Notter K.M. Menstrual reduction with extended use of combination oral contraceptive pills: randomized controlled trial. Obstet Gynecol 2001; 98 (5): 771–8.Kwiecien M, Edelman A, Nichols M.D, Jensen J.T. Bleeding patterns and patient acceptability of standard or continuous dosing regimens of a low - dose oral contraceptive: a randomized trial. Contraception 2003; 67: 9–13.Anderson F.D, Hait H. A multicenter, randomized study of an extended cycle oral contraceptive. Contraception 2003; 68: 89–96.Wiegratz I, Kuhl H. Long - cycle treatment with oral contraceptives. Drugs 2004; 64 (21): 2447–62.Cachrimanidou A-C, Hellberg D, Nilsson S et al. Long - interval treatment regimen with a desogestrel - containing oral contraceptive. Contraception 1993; 48: 205–16.Steiner M. Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management J Psychiatry Neurosci 2000.Sulak P.J, Cressman B.E, Waldrop E et al. Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms. Obstet Gynecol 1997; 89: 179–83.Loudon N.B, Foxwell M, Potts D.M et al. Acceptability of an oral contraceptive that reduces the frequency of menstruation: the tri - cycle pill regimen. BMJ 1977; 2: 487–90.Sillem M, Schneidereit R, Heithecker R, et al. Use of an oral contraceptive containing drospirenone in an extended regimen. Eur J Contracept Reprod Health Care 2003; 8: 162–9.