How is PMS treated?

Progesterone is the gold standard treatment for PMS. Progesterone is the hormone released by the ovary once ovulation has taken place. Pure progesterone, also called natural progesterone, is significantly different from synthetic pharmaceutical progestins (also called progestagens) which do not work in treating PMS.

If you are young, sexually active, and desire contraception, then your doctor may suggest a prescription for birth control pills to control your PMS. Your PMS symptoms may respond because the Pill prevents ovulation and overrides your fluctuating hormone levels. Your periods will be lighter, and you may have fewer cramps. However, the Pill is not a suitable solution if you :

• Excess estrogen hormone
• Have migraines, high blood pressure, diabetes,
  heart disease,prior stroke, or a clotting disorder
• Difficulty concentrating
• Are older than 35
• Are a staunch Catholic

The known side-effects of birth control pills are: Acne; nausea; headaches; bloating; breast tenderness; breakthrough bleeding between periods; decreased sexual interest (libido); benign liver tumors; and a slightly increased chance of developing breast cancer. Combination birth control pills that contain estrogen and progestin may aggravate your symptoms.

Natural progesterone injections are inefficient because they require daily top-ups due to the short half-life of progesterone. Their use is restricted to assisted fertility programs. Medroxyprogesterone acetate (Depo-Provera®) is a synthetic progestin injection sometimes used for severe PMS or PMDD that temporarily stops ovulation.

Unfortunately, Depo-Provera® often increases the signs and symptoms of PMS, especially increased appetite, weight gain, headache and depression. Unlike injections, natural progesterone cream (Pro-Feme®)
is painless and gives an even dose of pure progesterone with
minimal side effects.

Oral progesterone capsules are not absorbed well by the human body because progesterone does not dissolve in water. Oral progesterone capsules require a fat like cocoa butter or peanut oil to dissolve and many people are allergic to peanuts. Only about 20% of the oral dose reaches the relevant cells. The rest is metabolized by the liver (first-pass effect).

Medroxyprogesterone tablets are a cheap synthetic progestin that is similar in chemical structure to natural progesterone, but extremely limited in its spectrum of action when compared to real progesterone.It is sold as Provera® or as a generic medicine, and is commonly used to treat heavy menstrual bleeding and severe PMS. Medroxyprogesterone may cause birth defects if the woman accidentally becomes pregnant.

It passes into breast milk and may damage the infant, so it is not suitable for postnatal depression. Medroxyprogesterone increases the risk of blood clots, especially if you smoke. It can cause depression, suicidal feelings, and dementia. It predisposes women to breast, ovarian, and uterine cancer. If medroxyprogesterone is used long term, it may increase the risk of stroke and heart attack.

The minor side effects of synthetic medroxyprogesterone are weight gain, itchy skin rash, acne, hair loss, insomnia, bloating, menstrual irregularities, vaginal discharge and tender breasts. Many doctors mistakenly think Provera® is the same hormone as progesterone and also many medical texts fail to differentiate between real progesterone and synthetic analogues such as medroxyprogesterone acetate.

PMS responds best to true progesterone. Natural progesterone is best used as a topical cream or a vaginal or rectal suppository. Most PMS suffers and prescribers opt for the more easily absorbed natural progesterone cream (Pro-Feme® Lawley Pharmaceuticals, Australia) that you can apply to your skin, which has fewer, less intense side-effects than the progestins.

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