West C P
Department of Obstetrics and Gynaecology, University of Edinburgh, Scotland.
Eur J Obstet Gynecol Reprod Biol. 1990 Jan-Feb;34(1-2):119-28. doi: 10.1016/0028-2243(90)90015-s.
Forty-eight women with premenstrual problems were recruited for therapy with either medroxyprogesterone (MPA) or norethisterone (NET), both compared with placebo, in a double-blind cross-over study. Thirty-five (73%) completed the study. At an oral dose of 15 mg daily for 21 days each cycle, both MPA and NET suppressed ovulation, although reduction of urinary total oestrogen excretion was significantly greater with NET. Breakthrough bleeding occurred in 74% of the cycles treated with MPA but only in 22% of those with NET. Symptoms were monitored daily by visual analogue scales. Both progestins significantly reduced breast discomfort, compared with placebo. While MPA significantly improved individual psychological symptom scores by the second active treatment cycle and pooled psychological symptom scores in both active cycles, NET was no more effective than the placebo. Similar numbers from both groups withdrew because of adverse effects. Among the women treated with MPA, the response to active and placebo therapy was related to the pretreatment psychological symptom profile. The results suggest that the beneficial effect of therapy with MPA in women with premenstrual problems was a consequence of disruption of menstrual cyclicity rather than a result of ovulation suppression.
在一项双盲交叉研究中，招募了48名有经前问题的女性，她们被分为两组，分别接受甲羟孕酮（MPA）或炔诺酮（NET）治疗，并与安慰剂组进行比较。35名（73%）女性完成了该研究。每个周期口服15毫克，每日一次，共21天，MPA和NET均能抑制排卵，不过NET使尿总雌激素排泄量的减少更为显著。接受MPA治疗的周期中有74%出现突破性出血，而接受NET治疗的周期中仅22%出现突破性出血。每天通过视觉模拟量表监测症状。与安慰剂相比，两种孕激素均能显著减轻乳房不适。在第二个有效治疗周期，MPA显著改善了个体心理症状评分，且在两个有效周期中合并心理症状评分也显著改善，而NET并不比安慰剂更有效。两组因不良反应退出的人数相近。在接受MPA治疗的女性中，对有效治疗和安慰剂治疗的反应与治疗前的心理症状特征有关。结果表明，MPA治疗对有经前问题的女性产生有益效果是月经周期紊乱的结果，而非抑制排卵的结果。
