Svojanovská K
MEDICONET s.r.o., Brno.
Ceska Gynekol. 2010 Oct;75(5):474-80.
The efficiency of oral contraception containing drospirenone in treating symptoms of premenstrual dysphoric disorder (PMDD) was demonstrated in a number of studies. The objective of this observation was to use the "Premenstrual Symptoms Screening Tool" (PSST) to identify women who suffer from severe premenstrual syndrome (PMS) or PMDD and evaluate the benefits of their treatment through using the oral contraceptive containing drospirenone in regime 24/4 in gyneacology practice.
The retrospective study was conducted from September 2008 to August 2009. Fifty-one women met by the PSST (Premenstrual Symptoms Screening Tool, Steiner et. al., 2003) the criteria of severe PMS/PMDD. Twenty-eight women took no contraception at the start of the evaluation and twenty-three already took oral contraceptives before changing to the oral contraceptive with drospirenone. The women completed the PSST and in the case of severe PMS/PMDD started treatment with the oral contraceptive containing 20 microg ethinylestradiol /EE/ + 3 mg drospirenone /drsp/ in regime 24/4. The next evaluation was conducted by the same PSST after 3 or 4 months of treatment with this oral contraceptive.
The study involved 51 women between the ages of 15 and 44 years (average 25.7 years), who completed the PSST before and after 3 or 4 months of treatment with the oral contraceptive containing drospirenone. The summary score of all subjects significantly decreased from 24.6 before they started using the oral contraceptive with drospirenone to 7,2 after 3 or 4 months of treatment with this oral contraceptive. Significant declines in summary scores have been shown in both groups (in the group without oral contraception from 24.9 at the start of the observation to 8.2 after 3 or 4 months of using this oral contraceptive with drospirenone; and from 24.3 to 6.0 in the group with the change from using various oral contraceptives to using the contraceptive containing drospirenone).
The application of PSST for detection of severe premenstrual symptoms facilitates route identification diagnosis of severe PMS/PMDD in practice and also allows the evaluation of treatment. Both in the group of women without oral contraceptive at the start of the evaluation and in the group of women who changed to the oral contraceptive, symptoms significantly decreased after 3 or 4 months of treatment with the oral contraceptive containing drospirenone and severe PMS and PMDD was practically eliminated. In the case of diagnosis of severe PMS/PMDD in women wishing to use an oral contraceptive, it is important to start treatment with the oral contraceptive containing drospirenone and for women with severe PMS/PMDD symptoms when using different oral contraceptives, it is important to change to the contraception with drospirenone.
多项研究已证实含屈螺酮的口服避孕药在治疗经前烦躁障碍（PMDD）症状方面的有效性。本观察的目的是使用“经前症状筛查工具”（PSST）来识别患有严重经前综合征（PMS）或PMDD的女性，并在妇科实践中通过使用24/4方案含屈螺酮的口服避孕药来评估其治疗效果。
回顾性研究于2008年9月至2009年8月进行。51名女性通过PSST（经前症状筛查工具，施泰纳等人，2003年）符合严重PMS/PMDD的标准。28名女性在评估开始时未采取避孕措施，23名女性在改用含屈螺酮的口服避孕药之前已经在服用口服避孕药。这些女性完成了PSST，对于严重PMS/PMDD患者开始使用含20微克炔雌醇（/EE/）+3毫克屈螺酮（/drsp/）的口服避孕药进行24/4方案治疗。在用这种口服避孕药治疗3或4个月后，再次使用相同的PSST进行评估。
该研究纳入了51名年龄在15至44岁之间（平均25.7岁）的女性，她们在使用含屈螺酮的口服避孕药治疗3或4个月前后完成了PSST。所有受试者的总分从开始使用含屈螺酮的口服避孕药前的24.6显著降至使用该口服避孕药治疗3或4个月后的7.2。两组的总分均有显著下降（未采取避孕措施组从观察开始时的24.9降至使用含屈螺酮的口服避孕药3或4个月后的8.2；从使用各种口服避孕药改为使用含屈螺酮避孕药的组从24.3降至6.0）。
应用PSST检测严重经前症状有助于在实践中对严重PMS/PMDD进行路径识别诊断，也有助于评估治疗效果。在评估开始时未采取口服避孕措施的女性组以及改用口服避孕药的女性组中，使用含屈螺酮的口服避孕药治疗3或4个月后症状均显著减轻，严重PMS和PMDD实际上已消除。对于希望使用口服避孕药的女性诊断为严重PMS/PMDD时，重要的是开始使用含屈螺酮的口服避孕药进行治疗；对于使用不同口服避孕药时有严重PMS/PMDD症状的女性，重要的是改用含屈螺酮的避孕药。
