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Calcium supplementation in premenstrual syndrome

A randomized crossover trial

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Abstract

Objective:To determine the efficacy of calcium supplementation in women with premenstrual syndrome (PMS).

Design:Randomized, double-blind crossover trial.

Setting:Outpatient medical clinic of a large city hospital.

Particlpants:Seventy-eight women were initially screened. Trial selection was based on a history of recurrent PMS symptoms and on the results of a prospective assessment of daily symptom scores. Only women with symptom scores during the late luteal phase that were at least 50% greater than those during the intermenstrual phase were selected. Thirty-three women completed the trial.

Intervention:A preliminary evaluation included physical examination, routine laboratory tests, dietary assessment, and psychiatric evaluation. Each participant received six months of treatment involving three months of daily calcium supplementation (1,000 mg of calcium carbonate) and three months of placebo.

Measurements:Efficacy was assessed prospectively by changes in daily symptom scores over a six-month period and retrospectively by an overall global assessment. Multivariate repeated measures analysis of variance on symptom ratings derived from daily PMS symptom scores demonstrated a reduction in symptoms on calcium treatment during both the luteal (p=0.011) and the menstrual phases (p=0.032) of the reproductive cycle. Calcium supplementation had no effect during the intermenstrual phase. Retrospective assessment of overall symptoms confirmed this reduction: 73% of the women reported fewer symptoms during the treatment phase on calcium, 15% preferred placebo, and 12% had no clear preference. Three premenstrual factors (negative affect [p=0.045]; water retention [p=0.003]; pain [p=0.036]) and one menstrual factor (pain [p=0.02]) were significantly alleviated by calcium.

Conclusion:Calcium supplementation is a simple and effective treatment for premenstrual syndrome, but further studies will be needed to determine its precise role in PMS.

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References

  1. Frank RT. The hormonal causes of premenstrual tension. Arch Neurol Psychiatry. 1931; 26:1053–7.

    Google Scholar 

  2. Bruce J, Russell GPM. Premenstrual tension. A study of weight changes and balances of water, sodium and potassium. Lancet. 1962; 2:267–71.

    Article  PubMed  CAS  Google Scholar 

  3. Sampson GA. Premenstrual syndrome: a double blind controlled trial of progesterone and placebo. Br J Psychiatry. 1979; 135:209–15.

    Article  PubMed  CAS  Google Scholar 

  4. Stokes J, Mendels J. Pyridoxine and premenstrual tension. Lancet. 1972; 1:1177.

    Article  PubMed  CAS  Google Scholar 

  5. Coppen AJ, Milne HB, Outram DH, Weber JCP. Dytide, norethisterone and a placebo in the premenstrual syndrome. Clin Trial J. 1969; 9:33–5.

    Google Scholar 

  6. Williams MJ, Hanes RI, Dean BC. Controlled trial of pyridoxine in the premenstrual syndrome. J Int Med Res. 1985; 13:174–9.

    PubMed  CAS  Google Scholar 

  7. Reid RL, Yen SSC. Premenstrual syndrome. Am J Obstet Gynecol. 1981; 139:85–104.

    PubMed  CAS  Google Scholar 

  8. O’Brien PM, Faratian B, Gaspan A, et al. Quantification of premenstrual syndrome. In Taylor RW, ed. Premenstrual syndrome. London, Medical News-Tribune Ltd, 1983; 7–12.

    Google Scholar 

  9. Wardlaw SL, Wehrenberg WB, Ferin M, Antunes JL, Frantz AG. Effect of sex steroids onβ-endorphin in hypophyseal portal blood. J Clin Endocrinol Metab. 1982; 55:877–81.

    PubMed  CAS  Google Scholar 

  10. Backstrom T, Cartensen H. Oestrogen and progesterone in plasma in relation to premenstrual tension. J Steroid Biochem. 1974; 5:257–60.

    Article  PubMed  CAS  Google Scholar 

  11. Abraham GE, Hargrove JT. Effect of vitamin B6 on premenstrual symptomatology in women with premenstrual tension syndrome: a double blind crossover study. Infertility. 1980; 3:155–65.

    Google Scholar 

  12. Israel SL. Premenstrual tension. JAMA 1938; 110:1721–31.

    Google Scholar 

  13. Muse KN, Cetel NS, Futterman LA, Yen SSC. The premenstrual syndrome: effects of medical ovariectomy. N Engl J Med. 1984; 311:1345–9.

    Article  PubMed  CAS  Google Scholar 

  14. Moos R. The development of a menstrual distress questionnaire. Psychomat Med. 1968; 30:853–66.

    CAS  Google Scholar 

  15. Maddocks S, Hahn P, Moller F, Reid R. A double-blind placebocontrolled trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome. Am J Obstet Gynecol. 1986; 154:573–81.

    PubMed  CAS  Google Scholar 

  16. Kendall K, Schnurr P. Effects of vitamin B6 supplementation on premenstrual symptoms. Obstet Gynecol. 1987; 70:145–9.

    PubMed  CAS  Google Scholar 

  17. Harvey AM, MacIntosh FC: Calcium and synaptic transmission in a synaptic ganglion. J Physiol. 1940; 97:408–16.

    PubMed  CAS  Google Scholar 

  18. McCarthy DM, Sheehan JD. The role of calcium ions in salivary secretion. J Physiol. 1968; 184:81–82p.

    Google Scholar 

  19. Sandow A: Excitation-contraction coupling in muscular response. Yale J Biol. 1952; 25:176–201.

    PubMed  CAS  Google Scholar 

  20. Lehninger AL, Carafole E, Rossi CS. Energy-linked ion movements in mitochondrial systems. Advances Enzymol. 1967; 29:259–320.

    CAS  Google Scholar 

  21. Munday M. Progesterone and aldosterone levels in the premenstrual syndrome. J Endocrinol. 1977; 73:21p.

    Google Scholar 

  22. Munday M, Brush MG, Taylor RW. Correlates between progesterone, oestradiol and aldosterone levels in the premenstrual syndrome. Clin Endocrinol. 1981; 14:1–9.

    CAS  Google Scholar 

  23. Butt WR, Watts JF, Holder G. The biochemical background to premenstrual syndrome. In Taylor RW, ed. Premenstrual syndrome. London, News-Tribune Ltd., 1983; 16–24.

    Google Scholar 

  24. O’Brien PMS, Selby C, Symonds EM. Progesterone, fluid and electrolytes in premenstrual syndrome. Br Med J. 1980; 280:1161–3.

    Article  PubMed  CAS  Google Scholar 

  25. Backstrom T, Sanders D, Leask R, Davidson D, Warner P, Bancroft J. Mood, sexuality, hormones and the menstrual cycle. II. Hormones and their relationship to the premenstrual syndrome. Psychosom Med. 1983; 45:503–7.

    PubMed  CAS  Google Scholar 

  26. Andersch B, Abrahamsson L, Wenderstem C, et al. Hormone profiles in premenstrual tension: effects of bromocriptine and diuretics. Clin Endocrinol. 1979; 11:657–64.

    CAS  Google Scholar 

  27. Pritkin RM, Reynolds WA, Williams GA, Hargis KH. Calcium-regulating hormones during the menstrual cycle. J Clin Endocrinol Metabol. 1978; 47:626–32.

    Google Scholar 

  28. Gray TK, McAdoo T, Hartley L, Lester GE, Thierry M. Fluctuations of serum concentrations of 1,25-dihydroxyvitamin D3 during the menstrual cycle. Am J Obstet Gynecol. 1982; 14:880–4.

    Google Scholar 

  29. Muse KN, Manolagas SC, Deftos IJ, Alexander N, Yen SSC. Calcium-regulating hormones across the menstrual cycle. J Clin Endocrinol Metab. 1986; 62:1313–6.

    Article  PubMed  CAS  Google Scholar 

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Received from the Section of General Internal Medicine, Department of Medicine, Metropolitan Hospital, New York Medical College, New York, New York.

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Thys-Jacobs, S., Ceccarelli, S., Bierman, A. et al. Calcium supplementation in premenstrual syndrome. J Gen Intern Med 4, 183–189 (1989). https://doi.org/10.1007/BF02599520

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