Rapkin Andrea J
Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Center for Health Sciences, 10833 Le Conte Avenue, Los Angeles, CA 90095-1740, USA.
J Reprod Med. 2008 Sep;53(9 Suppl):729-41.
Premenstrual disorders negatively affect millions of U.S. women. The premenstrual disorder at the most severe end of the spectrum is premenstrual dysphoric disorder (PMDD). The specific diagnostic criteria developed for PMDD and the availability of validated symptom diaries have allowed a more organized study of severe premenstrual disorders. The U.S Food and Drug Administration has now approved 4 agents for the treatment of PMDD: 3 antidepressants (i.e., selective serotonin reuptake inhibitors) and 1 low-dose combination oral contraceptive (COC) that contains the progestin drospirenone and is administered using a regimen of 24 days of active pills in a 28-day cycle (drospirenone/20EE-24/4). Drospirenone is unique among progestins used in COCs in that it has both antimineralocorticoid and antiandrogenic activities. Two pivotal studies have shown drospirenone/20EE-24/4 to be effective in treating the mood, physical and behavioral symptoms of PMDD and symptoms specifically associated with food, water retention and negative interpersonal relationships.
经前疾病对数百万美国女性产生负面影响。经前疾病谱系中最严重的是经前烦躁障碍（PMDD）。为PMDD制定的特定诊断标准以及经过验证的症状日记的可用性，使得对严重经前疾病的研究更加有条理。美国食品药品监督管理局现已批准4种药物用于治疗PMDD：3种抗抑郁药（即选择性5-羟色胺再摄取抑制剂）和1种低剂量复方口服避孕药（COC），该避孕药含有孕激素屈螺酮，在28天周期内采用24天活性药丸的给药方案（屈螺酮/20炔雌醇-24/4）。屈螺酮在用于复方口服避孕药的孕激素中是独特的，因为它具有抗盐皮质激素和抗雄激素活性。两项关键研究表明，屈螺酮/20炔雌醇-24/4在治疗PMDD的情绪、身体和行为症状以及与食物、水潴留和负面人际关系特别相关的症状方面有效。
