Premenstrual Syndrome and Spironolactone

A double blind placebo controlled randomized cross over study was conducted to assess the response to spironolactone by patients suffering from 'Premenstrual Syndrome'. Somatic and neuropsychiatric symptoms were self-assessed daily and a total score was calculated for each symptom for the 14 days prior to menstruation. No significant difference was noted for the symptoms assessed on or off spironolactone. The levels of oestradiol, progesterone and prolactin showed no changes from the first to the second half of the cycle. In those patients who did respond to spironolactone, a significant difference in androgen levels from the follicular to the luteal phase of the cycle prior to treatment was demonstrated. Significant differences in androgen levels from the follicular to the luteal phase of the menstrual cycle may therefore be an important determinant in predicting those patients with premenstrual syndrome likely to respond to spironolactone therapy.