Premenstrual Syndromes : PMS and PMDD - Rutuja :: The site ...

The other study comprised 105 patients treated over 3
months. 17 By the end of this treatment, symptom scores
were lower in the homeopathically treated group compared
with the placebo group. There was also less use
of tranquillizers and analgesics and fewer work days
lost than in the placebo group. Vis-à-vis these contradictory
findings, no definitive conclusions about the
value of homeopathy for PMDD are possible.
Massage
An RCT of massage therapy for 24 women with PMDD
reported some improvements in symptoms immediately
after massage sessions and after 1 month of treatment.
However, the mood symptoms that are central to PMDD
were not lowered at 1 month. Relaxation was used as a
control, but intergroup analyses were not conducted. 18
The effectiveness of massage for PMDD therefore remains
speculative.
Reflexology
An RCT (n � 35) of reflexology applied once weekly
for 2 months reduced both somatic and psychological
PMDD symptoms significantly more than sham reflexology,
which involved treating points unrelated to premenstrual
symptoms. 19 This study needs independent
replication before recommendations can be made.
Relaxation
Progressive muscle relaxation training (twice weekly for
3 months) alleviated physical symptoms of PMDD in
an RCT (n � 46) compared with the control interventions
of reading and charting symptoms. 20 For women
with severe complaints, there were also improvements
COMPLEMENTARY AND ALTERNATIVE THERAPIES 145
in emotional symptoms. Independent replications of these
data are required.
Spinal manipulation
A cross-over RCT of chiropractic manipulation included
25 PMDD patients. Superior results were noted for
spinal manipulation compared with a sham treatment. 21
However, improvements were greatest with whichever
intervention was received first. Therefore the perceived
benefits may not be due to specific effects of spinal
manipulation.
Dietary supplements
Calcium
Calcium supplementation has been demonstrated to be
superior to placebo for most types of PMDD symptoms
in two double-blind RCTs (Table 16.5). 22,23 The second
of these trials is impressive in terms of size (n � 466)
and methodological rigor and provides promising evidence
in favor of calcium.
Magnesium
Two small double-blind RCTs of magnesium supplements
have indicated some benefits over placebo. 24,25
However, the type of symptoms that improved was different
in each study. The data are therefore not compelling
and require independent replication.
Neptune Krill
Table 16.5 Double-blind RCTs of calcium for premenstrual syndrome
Neptune Krill Oil has been compared to fish oil in an
RCT with 70 women. 26 The results suggest that both
have similar effects on dysmenorrhea and symptoms of
Reference Sample size Interventions [dosage] Result Comment
Thys-Jacobs et al22 33 (A) Calcium [1000 mg/day A was superior Cross-over trial; high
for 3 months] in 3 of 4 symptoms drop-out rate;
(B) Placebo non-compliance
Thys-Jacobs et al23 466 (A) Calcium [1200 mg/day A was superior Trial was rigorous
for 3 months] in all symptoms but not all other
(B) Placebo treatments were
excluded