From the FDA Drug Label
What is progesterone capsules used for? Treatment of Menstrual Irregularities Progesterone capsules are used for the treatment of secondary amenorrhea (absence of menstrual periods in women who have previously had a menstrual period) due to a decrease in progesterone When you do not produce enough progesterone, menstrual irregularities can occur.
The role of progesterone treatment for Premenstrual Dysphoric Disorder (PMDD) is not explicitly stated in the provided drug label. Key points:
- The label mentions treatment of menstrual irregularities, but does not specifically address PMDD.
- The label does discuss the use of progesterone for secondary amenorrhea, but this is not the same as PMDD. 1
From the Research
Progesterone treatment is not recommended as a first-line therapy for Premenstrual Dysphoric Disorder (PMDD), and instead, selective serotonin reuptake inhibitors (SSRIs) and combined oral contraceptives containing drospirenone are preferred treatments. The most effective treatments for PMDD include SSRIs such as fluoxetine (20mg daily), sertraline (50-150mg daily), or escitalopram (10-20mg daily), which can be taken either continuously or only during the luteal phase (14 days before menstruation) 2. Despite the logical assumption that progesterone might help PMDD since symptoms occur during the luteal phase when progesterone levels fluctuate, clinical studies have not consistently supported its effectiveness. In fact, synthetic progestins found in some hormonal contraceptives may worsen mood symptoms in sensitive individuals 3.
For those seeking hormonal approaches, combined oral contraceptives containing drospirenone (like Yaz or Yasmin) have FDA approval for PMDD treatment and work by suppressing ovulation and stabilizing hormone levels 4. However, a recent study found that ulipristal acetate, a selective progesterone receptor modulator, may be a useful treatment for PMDD, particularly for the psychological symptoms associated with the disorder 5.
Lifestyle modifications including regular exercise, stress management techniques, and dietary changes (reducing caffeine, alcohol, and sugar) should accompany any medication treatment. If considering progesterone despite these caveats, consultation with a healthcare provider specializing in reproductive psychiatry or gynecology is essential to discuss potential benefits versus risks for your specific situation. Key considerations for treatment include:
- Selective serotonin reuptake inhibitors (SSRIs) as first-line treatment
- Combined oral contraceptives containing drospirenone as an alternative hormonal approach
- Ulipristal acetate as a potential new treatment option
- Lifestyle modifications to support overall well-being
- Consultation with a healthcare provider to determine the best treatment plan for individual needs.