The end of PMS?
By Anna Khot
Premenstrual syndrome (PMS) has been prevented by giving low doses of a commonly prescribed anti-anxiety drug. The study, on rats, gives hope to PMS sufferers around the world, said Dr Thelma Lovick at the British Science Festival yesterday.
The organic cause for PMS was identified by UK scientists.
Dr Lovick, of the University of Birmingham, predicts that taking only 2mg fluoxetine (Prozac) daily, when PMS symptoms start to emerge, will be enough to achieve a PMS-free period. The normal dose for anxiety or depression is between 10-20mg, she said.
Common drug
Countless women could benefit from "a simple and accessible treatment involving a drug already in widespread use," said Lovick.
She proposes taking a low dose of the drug in the days running up to the period, when PMS is most likely to occur.
The low dose would take effect within hours when being used to treat PMS. When taken for its anti-anxiety effects, the drug takes around two weeks to start working.
PMS causes misery for millions of women worldwide every month. Psychological symptoms include "anxiety, mood swings, tiredness, irritability, depression, a loss of confidence, and clumsiness," said Lovick. "Physical changes such as headaches, feeling bloated, altered appetite, joint pain and breast tenderness may also be experienced," she added.
Hormonal activity
At the beginning of the menstrual cycle, levels of the hormone progesterone increase. This is involved in preparing the lining of the uterus for a fertilised egg. If the egg is not fertilised, progesterone levels decline which is when PMS symptoms develop.
Progesterone is a hormone which circulates in the blood stream. One of its breakdown products is a steroid substance called allopregnanolone (ALLO). It is ALLO that inhibits activity in the brain circuits which are involved in controlling emotions.
When ALLO levels drop, as occurs during the premenstrual period, the inhibition is reduced and symptoms of PMS emerge.
"ALLO normally produces calming effects," said Lovick.
In the study, dosing with fluoxetine was carefully timed to boost brain ALLO levels just when they were due to fall sharply at the end of the cycle. This meant that the normal trigger for the development of PMS was absent, said Lovick.
Simple solution
Referring to rats, Lovick said, "[fluoxetine] completely changed the way in which the brain circuits responded to anxiety-inducing stress. It completely prevented the development of the signs of anxiety and increased pain and sensitivity normally shown by female rats in their version of the premenstrual period."
This treatment is unlikely to work for a small percentage of women, around three to four per cent, who suffer from a psychiatric condition called Premenstrual Dysphoric Disorder (PMDD).
Lovick and her colleague are now seeking a clinical partner to confirm their laboratory findings and fund a clinical trial.
"The time is right for a controlled clinical trial in women. The solution to PMS could be as simple as taking a pill for a few days towards the end of your menstrual cycle," she said.
However, the temporary effect of this type of drug (an SSRI), and the dose regimen suggested was questioned by Professor Nikolas Rose of LSE, it "sits badly with what is known of the mode of action of these drugs," he said.
"I would, in general, caution against the use of pharmaceuticals that have significant and not fully understood effects on brain chemistry for conditions that can be managed in other ways, and be wary of any suggestions that such drugs can act as 'magic bullets' for a specific condition. Such hopes are usually misguided," he added.
Premenstrual syndrome (PMS) has been prevented by giving low doses of a commonly prescribed anti-anxiety drug. The study, on rats, gives hope to PMS sufferers around the world, said Dr Thelma Lovick at the British Science Festival yesterday.
The organic cause for PMS was identified by UK scientists.
Dr Lovick, of the University of Birmingham, predicts that taking only 2mg fluoxetine (Prozac) daily, when PMS symptoms start to emerge, will be enough to achieve a PMS-free period. The normal dose for anxiety or depression is between 10-20mg, she said.
Common drug
Countless women could benefit from "a simple and accessible treatment involving a drug already in widespread use," said Lovick.
She proposes taking a low dose of the drug in the days running up to the period, when PMS is most likely to occur.
The low dose would take effect within hours when being used to treat PMS. When taken for its anti-anxiety effects, the drug takes around two weeks to start working.
PMS causes misery for millions of women worldwide every month. Psychological symptoms include "anxiety, mood swings, tiredness, irritability, depression, a loss of confidence, and clumsiness," said Lovick. "Physical changes such as headaches, feeling bloated, altered appetite, joint pain and breast tenderness may also be experienced," she added.
Hormonal activity
At the beginning of the menstrual cycle, levels of the hormone progesterone increase. This is involved in preparing the lining of the uterus for a fertilised egg. If the egg is not fertilised, progesterone levels decline which is when PMS symptoms develop.
Progesterone is a hormone which circulates in the blood stream. One of its breakdown products is a steroid substance called allopregnanolone (ALLO). It is ALLO that inhibits activity in the brain circuits which are involved in controlling emotions.
When ALLO levels drop, as occurs during the premenstrual period, the inhibition is reduced and symptoms of PMS emerge.
"ALLO normally produces calming effects," said Lovick.
In the study, dosing with fluoxetine was carefully timed to boost brain ALLO levels just when they were due to fall sharply at the end of the cycle. This meant that the normal trigger for the development of PMS was absent, said Lovick.
Simple solution
Referring to rats, Lovick said, "[fluoxetine] completely changed the way in which the brain circuits responded to anxiety-inducing stress. It completely prevented the development of the signs of anxiety and increased pain and sensitivity normally shown by female rats in their version of the premenstrual period."
This treatment is unlikely to work for a small percentage of women, around three to four per cent, who suffer from a psychiatric condition called Premenstrual Dysphoric Disorder (PMDD).
Lovick and her colleague are now seeking a clinical partner to confirm their laboratory findings and fund a clinical trial.
"The time is right for a controlled clinical trial in women. The solution to PMS could be as simple as taking a pill for a few days towards the end of your menstrual cycle," she said.
However, the temporary effect of this type of drug (an SSRI), and the dose regimen suggested was questioned by Professor Nikolas Rose of LSE, it "sits badly with what is known of the mode of action of these drugs," he said.
"I would, in general, caution against the use of pharmaceuticals that have significant and not fully understood effects on brain chemistry for conditions that can be managed in other ways, and be wary of any suggestions that such drugs can act as 'magic bullets' for a specific condition. Such hopes are usually misguided," he added.
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