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Placebo responsiveness was monitored in 29 women presenting with the premenstrual syndrome (PMS). Daily records were kept during six menstrual cycles (three control and three placebo)and weekly urine samples collected for the measurement of pregnanediol. Psychological and physical symptom cyclicity was analyzed by Fourier analysis. Placebo administration was associated with a significant amelioration of premenstrual symptoms in the group as a whole which persisted during the 3 months of treatment; marked variations in the placebo responsiveness of individuals; and a previously unreported and significant shift in the mean position of psychological symptoms to within a few hours of menstrual onset. The cause of this shift is discussed.Beobachtet wurde die Reaktion von 29 Frauen mit pramenstruellem Syndrom (PMS) auf die Gabe von Placebos. Es wurden Tagesprotokolle Uber sechs Menstruationszyklen hinweg (Kontrolle: dreiPlacebo: drei) gefUhrt und wochentlich Urinproben zur Messung von Pregnandiol genommen. Mit ...

Seven moods and 5 physical symptoms have been observed daily throughout the course of 133 menstrual cycles, in 44 women with the premenstrual syndrome (PMS). The evidence suggests the existence of 2 symptom cyclicities, the first with symptoms appearing early in the luteal phase and reaching a maximum close to the end of the menstrual cycle, and the second with symptoms appearing late in the luteal phase and reaching a maximum on the first or second day of the new cycle. Only headaches followed the second pattern. Headaches, unlike the other PMS symptoms, were symmetrically distributed about day 0 in the menstrual cycle with 53.8% of the peak area occurring in the 10 days before the start of menstruation (95% range, 38.6–68.7%). By comparison, the premenstrual percentages for the 7 moods and for bloating, constipation, food craving and breast discomfort ranged from 77.8 to 93.4% (mean ± S.D., 84.3 ± 6.1%) indicating that these symptoms occur mainly in the premenstruum. It is concluded that headaches are a...

To assess ovarian function plasma luteinizing hormone and follicle stimulating hormone urinary estrogen and urinary pregnanediol levels were measured weekly for 4 weeks in 34 women (aged 45-57) who had withdrawn from oral contraceptives (OCs). 14 patients were classified as premenopausal after a rise in urinary pregnanediol excretion occurred suggesting ovulation had occurred. 13 were classified as postmenopausal on the basis of elevated serum gonadotropins and persistently low urinary estrogen and pregnanediol excretion. However 1 of the women later showed hormonal evidence of ovulation indicating fluctuation in ovarian function. 7 patients were classified as indeterminate; their hormone profiles made ovarian function hard to assess. All patients excreting more than 45 nmal of estrogen/day had a spontaneous menstrual period within 45 days of stopping OCs. This suggests that women who are potentially fertile at 1 month after discontinuing OCs can be identified with an early morning urine sample; a slight improvement in accuracy is obtained if sampling is also carried out after 3 weeks. However because of the 1 woman in this study who was thought to be postmenopausal but later turned out to have increased pregnanediol excretion suggesting ovulation caution is advised in diagnosing menopause on the basis of hormone studies alone.

The administration of human chorionic gonadotrophin (HCG) to dexamethasone-suppressed men caused parallel changes in the concentration of plasma testosterone and in the urinary output of androsterone+aetiocholanolone, total 17-oxosteroids and oestrogens. Discrepant results occurred in only four of the thirty-seven men tested. With these exceptions, the response to HCG could by followed as well by measuring androsterone+aetiocholanolone, 17-oxosteroid or oestrogen excretion rates as by following plasma testosterone levels. The most sensitive index of response was the rate of appearance of oestrogens in urine, and the next that of androsterone+aetiocholanolone.

Hysterectomy is sometimes recommended for the treatment of women with the premenstrual syndrome (PMS). Do the symptoms of PMS disappear when the uterus is removed?The moods and physical symptoms ex...