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Department of Obstetrics and Gynecology Progesterone Therapy for PMS

Progesterone therapy is effective for some women with premenstrual symptoms. Not all women with PMS are helped. Our goal is to try to reduce the unpleasant symptoms you experience before your menstrual period and at the same time keep the amount of medication you must take to a minimum. Progesterone used in these doses is not FDA (Food and Drug Administration) approved. We are using it on an experimental basis. Oral Progesterone: This form of progesterone is surrounded by a coated capsule. This is to prevent the acidity of the stomach from destroying the progesterone before it is absorbed. This is probably the most convenient form of progesterone to use. Oral progesterone is prescribed in capsules or tablets. Capsules are dispensed in 100 mg doses. The usual treatment is one capsule taken in the morning and two capsules at bedtime. Tablets are compounded to provide even release of the progesterone into the bloodstream. The tablets are dispensed in 200 mg doses and the usual treatment is one tablet in the morning and one at bedtime. The medication is usually taken on days 14-28 of the menstrual cycle (during the time you are having symptoms). Adjusting Dosage: Sometimes the total number of days the progesterone is used can be reduced. A rule of thumb, the medication should be started three to four days before severe symptoms begin. As an example, some women who have symptoms lasting only three to four days may need to take the progesterone only seven or eight days of the month. Some women will need a larger daily dose of progesterone. If you notice some effect from the progesterone but not as complete as you think it might be, an increase in dose may help. It is best to discuss dosage changes with a PMS Clinic staff member. Side Effects of Progesterone: As far as we know there are no serious long term side effects of progesterone. As research is being done in this area we will find out more. However, women sometimes experience minor side effects. The most annoying is that of vaginal bleeding. The bleeding will rarely occur every day while the progesterone is being used or it may happen unpredictably. The menstrual period may also be delayed by a few days. Another possible side effect is drowsiness. Women who are taking too much progesterone may notice a "sedative-like" effect. This is easily adjusted by decreasing the daily dose. Finally, some women will notice that they are now having cramps with their menstrual periods that are more severe than before they were taking the progesterone. Over the counter Ibuprofen (Advil, Nuprin) can be used to help with the cramping. Summary: Remember that progesterone is not effective for all women with premenstrual symptoms. In order to determine whether it is effective for you, we feel that a two to three month trial is necessary. At the end of this time if you are not experiencing any relief of symptoms, we would recommend that the progesterone be discontinued. If you are noticing improvement, we will work with you to find the dose that is best for you. Remember all of the other components of the treatment of premenstrual syndrome are important, including diet, exercise and stress management. Difficult situations may arise occasionally even though you are on treatment that is usually effective. Try not to be discouraged by these times, next month is likely to be better. UI Health Care Home | About Us | Appointments | Contact Us | Departments | Health Library | Search Information for: Patients & Visitors | Health Care Professionals | Residents & Fellows | Students | Volunteers | Job Seekers | Alumni & Friends | Media | Business Partners