Published: 18-12-2020 13:23 | Updated: 18-12-2020 13:22

New promising treatment principle for premenstrual dysphoric disorder (PMDS)

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For the first time, a new study shows that treatment with a progesterone receptor modulator is effective for treatment of typical symptoms such as irritability and depression in women suffering from PMDS. The study, which was conducted at Uppsala University, Karolinska Institutet and Umeå University, has been published in the medical journal American Journal of Psychiatry.

Premenstrual dysphoric disorder (PMDS) is a condition that causes severe mental premenstrual symptoms with a significant negative impact on daily life and is affecting 3-5 percent of women of childbearing age. Today, the standard treatment is combined birth control pills or antidepressant serotonin reuptake inhibitors. These treatments are effective but are not suitable for all women.

The present study has investigated the effect of a selective progesterone receptor modulator (ulipristal acetate, UPA) which binds to the progesterone receptor and inhibits its effect in the brain. This substance, which is currently used to treat myoma, blocks ovulation and maintains estradiol and progesterone levels at constant moderate levels.

Researchers from Uppsala University, Karolinska Institutet and Umeå University have conducted a double-blind, randomized, placebo-controlled study of 95 women with PMDS showing that UPA effectively reduces mental symptoms such as irritability and depression in these women. The study, published in the American Journal of Psychiatry, furthermore shows that half of the patients who received UPA were completely asymptomatic, compared with 21 percent in the placebo group.

Helena Kopp Kallner, Lecturer senior, adjunct and Angelica Lindén Hirschberg, professor/specialist physician Photo: NA

The results provide increased knowledge  about the underlying mechanisms of the symptoms and can hopefully become a new treatment option for women with PMDS.

“It’s extremely fun that the clinical observations in the meeting with patients can be proved in scientific studies, that can lead to women being able to get better help”. Says Helena Kopp Kallner, senior lecturer and chief physician in gynecology at the Department of Clinical Sciences, KIDS.

The drug is only available in one product that’s not on the market today. Hopefully it will be available for treatment for PMDS in summer next year, depending on what the European Medicines Commission decides. 

Further information:

Helena Kopp Kallner, Lecturer senior, adjunct, Department of Clinical Sciences, Danderyd Hospital
Angelica Lindén Hirschberg, professor, Department of Women’s and Children’s Health, KI


Ulipristal Acetate for Treatment of Premenstrual Dysphoric Disorder: A Proof-of-Concept Randomized Controlled Trial.
Comasco E, Kopp Kallner H, Bixo M, Hirschberg AL, Nyback S, de Grauw H, et al
Am J Psychiatry 2020 Dec;():appiajp202020030286


Helena Kopp Kallner Senior Lecturer/Senior Physician