Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

Wyatt, Katrina; Dimmock, Paul; Jones, Peter; Obhrai, Manjit; O'Brien, Shaughn

doi:10.1136/bmj.323.7316.776

Cited by 168Menstrual Health and DisordersMenopause: Health Impacts and TreatmentsReproductive Health and Contraception

Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

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Wyatt, Katrina, Dimmock, Paul, Jones, Peter, Obhrai, Manjit, O'Brien, Shaughn·2001·BMJ

DOI 10.1136/bmj.323.7316.776PMC PMC57352

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Abstract

Objective: To evaluate the efficacy of progesterone and progestogens in the management of premenstrual syndrome. Design: Systematic review of published randomised, placebo controlled trials. Studies reviewed: 10 trials of progesterone therapy (531 women) and four trials of progestogen therapy (378 women). Main outcome measures: Proportion of women whose symptoms showed improvement with progesterone preparations (suppositories and oral micronised). Proportion of women whose symptoms showed improvement with progestogens. Secondary analysis of efficacy of progesterone and progestogens in managing physical and behavioural symptoms. Results: Overall standardised mean difference for all trials that assessed efficacy of progesterone (by both routes of administration) was −0.028 (95% confidence interval −0.017 to −0.040). The odds ratio was 1.05 (1.03 to 1.08) in favour of progesterone, indicating no clinically important difference between progesterone and placebo. For progestogens the overall standardised mean was −0.036 (−0.014 to −0.060), which corresponds to an odds ratio of 1.07 (1.03 to 1.11) showing a statistically, but not clinically, significant improvement for women taking progestogens. Conclusion: The evidence from these meta-analyses does not support the use of progesterone or progestogens in the management of premenstrual syndrome. What is already known on this topic: The premenstrual syndrome affects about 1.5 million women in the United Kingdom There are numerous treatment options, progesterone being one of the most strongly advocated Progesterone and progestogens are among the most widely prescribed treatments for premenstrual syndrome in the United Kingdom and the United States What this study adds: There is no evidence to support the claimed efficacy of progesterone in the management of premenstrual syndrome There is insufficient evidence to make a definitive statement about progestogens, but current evidence suggests that they are not likely to be effective

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Displaying summary statistics by group is helpful, because it allows an assessment of the severity of the problem in the studies, which is not available from between-group results.
“Displaying summary statistics by group is helpful, because it allows an assessment of the severity of the problem in the studies (such as level of depression symptoms), which is not available from between-group results (that is, effect estimates).137”
From PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews (2021) · cites this paper as [137]
The Statistical analysis section (page unavailable) describes a standardised mean difference as a dimensionless between-group effect estimate, supporting the distinction between effect estimates and group-level values. It does not say that displaying summary statistics by group helps readers assess the severity of symptoms in the studies. (LLM, conf=0.74)
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Authors: Wyatt, K., Dimmock, P., Jones, P., Obhrai, M., & O'Brien, S.
Affiliations: University Hospitals of North Midlands NHS Trust (GB)
ORCID: Wyatt, Katrina
Dimmock, Paul
Jones, Peter
Venue: BMJ
Publisher: BMJ
Published: 2001-10-06
Volume: 323
Issue: 7316
Pages: 776
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.323.7316.776
PMC: PMC57352
OpenAlex: W2148616825
Cited by: 168
References: 55
Citations by year: 2026: 2 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 10 · 2012: 14
FWCI: 2.33
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords: premenstrual syndrome, progesterone, progestogens, symptom improvement, treatment efficacy, placebo comparison
MeSH terms: Female, Humans, Premenstrual Syndrome, Progestins, Progesterone, Odds Ratio, Randomized Controlled Trials as Topic, Treatment Outcome

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Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review

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