Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Solberg, Julie

Keywords

Premenstrual Dysphoric Disorder, Selective Serotonin Reuptake Inhibitors, Progesterone, Fluoxetine, Premenstrual Syndrome, Sepranolone, Allopregnanolone, Luteal Phase, or Premenstrual

Abstract

Many women suffer from PMS/PMDD symptoms that affect their emotional and physical wellbeing. This research aimed to compare luteal phase treatment options for PMS/PMDD, such as SSRIs, progesterone, and sepranolone. The research was conducted using electronic search databases PubMed, Embase, CINHAL, Access Medicine, Cochrane Library, and NaProTECHNOLOGY Creighton Model FertilityCare System. Studies used in this research were found using keyword and MESH search terms. Each reviewed study was peer-reviewed, including randomized control trials or a meta-analysis. Among the treatments analyzed, SSRIs emerged as a consistent primary treatment for symptom alleviation, particularly in addressing cognitive symptoms associated with PMS/PMDD. SSRIs, at this time, are the current mainstay treatment and remain the recommended luteal phase treatment of PMS/PMDD. The studies examining various SSRIs, including citalopram, sertraline, escitalopram, and fluoxetine, examined the efficacy of these medications in relieving mood-related symptoms such as irritability, anxiety, and depression during the luteal phase. The data remains inconclusive when evaluating the efficacy of progesterone treatment in the luteal phase, leading to mixed outcomes based on timing treatment administration as it correlated to the exact timing of a woman's ovulation. Finally, ongoing exploration of allopregnanolone levels and the promising results of sepranolone treatment leads the way to a new understanding of hormonal mechanisms in PMS/PMDD. However, despite promising outcomes, sepranolone remains in trial and is not yet available for clinical use.

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