Premenstrual Symptoms and Hormonal Treatments: A Guide

Regarding menstruation?

Hello, doctor! I experience symptoms such as fatigue, excessive sleepiness, and weakness in the one to two weeks leading up to my menstrual period.
When I visited a gynecologist, the doctor prescribed me progesterone, but it doesn't seem to help much! Additionally, it delays my menstrual cycle—if I take progesterone, my period won't come, right? This is very troubling for me every month! I feel very tired during class, and my efficiency in doing anything is affected! However, I feel revitalized after my period ends! Also, I heard that hormonal medications shouldn't be taken too frequently; since progesterone is a type of hormone, doesn't taking it too much increase the risk of cancer? By the way, can premenstrual syndrome (PMS) also occur in young people around 18 years old? At what age does it typically start to diminish? Lastly, can I take birth control pills while on medication for premenstrual treatment?

Xiao Zhen, 10~19 year old female. Ask Date: 2012/12/28

Dr. Lin Wenbin reply Obstetrics and Gynecology

Progesterone can compensate for the insufficient luteal phase in cases of anovulation, helping to regulate menstrual cycles.
If there are concerns about delayed menstruation, the duration of progesterone administration can be shortened.
During menstruation, as female hormone levels decrease, some individuals may experience fatigue, discomfort, or even symptoms similar to menopause temporarily.
Maintaining daily exercise, adequate sleep, and a regular lifestyle can help improve these conditions.
Progesterone can prevent the development of endometrial cancer; however, excessive use may place a burden on the breasts.
Therefore, every medication has its benefits and drawbacks, and it is essential to use them under the guidance of a physician.
Premenstrual syndrome (PMS) is more likely to occur in younger individuals, but any menstruating woman can experience it, regardless of age.
As for the use of medications for premenstrual treatment in conjunction with contraceptives, this decision must be made after an evaluation by the prescribing physician.

Reply Date: 2012/12/28

More Info

Premenstrual symptoms, often referred to as premenstrual syndrome (PMS), can significantly affect a woman's quality of life in the days or weeks leading up to menstruation. Symptoms can include fatigue, sleep disturbances, mood swings, and physical discomfort, among others. Understanding these symptoms and the hormonal treatments available is crucial for effective management.

Your experience of fatigue, sleepiness, and weakness in the weeks before your period is common among many women. These symptoms are typically linked to hormonal fluctuations, particularly the changes in estrogen and progesterone levels that occur during the menstrual cycle. The use of hormonal treatments, such as progesterone (often referred to as "黄体素" or luteal hormone), is a common approach to managing these symptoms. However, as you've noted, progesterone can sometimes delay menstruation, which can be frustrating.

It's important to understand that while progesterone is a hormone that can help regulate the menstrual cycle and alleviate some PMS symptoms, it may not work for everyone. The effectiveness of hormonal treatments can vary based on individual hormonal balance, lifestyle, and other health factors. If you find that progesterone is not helping your symptoms and is causing unwanted side effects, it would be beneficial to discuss this with your healthcare provider. They may consider alternative treatments, such as lifestyle modifications, dietary changes, or different hormonal therapies.

Regarding your concern about the long-term use of hormonal medications and the potential risk of cancer, it's essential to have an open dialogue with your healthcare provider. While some studies have suggested a link between prolonged use of certain hormonal therapies and an increased risk of specific cancers, the risk is often context-dependent. Factors such as family history, personal health history, and the specific type of hormone therapy used play significant roles in determining risk. Your doctor can help assess your individual risk and discuss the benefits and drawbacks of continuing hormone therapy.

As for the age at which PMS symptoms may diminish, it varies widely among individuals. Many women experience PMS symptoms in their late teens and early twenties, and for some, these symptoms may lessen with age, particularly as they approach menopause. However, this is not a universal experience, and some women may continue to experience significant symptoms throughout their reproductive years.

Regarding the use of birth control pills in conjunction with PMS treatment, many healthcare providers prescribe hormonal contraceptives to help regulate menstrual cycles and alleviate PMS symptoms. Birth control pills can stabilize hormone levels, which may reduce the severity of PMS symptoms. However, it is crucial to discuss this option with your healthcare provider to ensure it aligns with your health needs and lifestyle.

In summary, managing premenstrual symptoms often requires a multifaceted approach, including lifestyle changes, dietary adjustments, and possibly hormonal treatments. If you are experiencing significant discomfort, it is essential to communicate openly with your healthcare provider about your symptoms, treatment effectiveness, and any concerns you may have regarding hormonal therapies. They can help tailor a treatment plan that best suits your individual needs and circumstances.

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