In December 2020, SciLifeLab (Sweden), published a study in the American Journal of Psychiatry regarding Ulipristal acetate as a promising new treatment for PMDD.

Ulipristal acetate is a progesterone receptor modulator with a partial progesterone antagonist effect. It suppresses ovulation in the majority of females who take it and has been used as a form of emergency contraception.

“Looking ahead, the researchers are currently investigating how progesterone receptor modulator affects the brain in women with PMDD. By neuroimaging the brain of these patients before and during treatment, using magnetic resonance imaging, the researchers aim to define structural and functional brain signatures that can explain the relief of PMDD symptoms.

The research results will be an important piece of the puzzle of improving our understanding of the mechanisms behind PMDD, the researchers say. Today, the first-line treatment for PMDD is serotonin reuptake inhibitors. Although these drugs are very effective, they are not suitable for all women and additional treatment options are of value. In addition, it would be desirable to have a treatment that more specifically addresses the mechanisms underlying this psychiatric disorder.”

Esmya (Ulipristal acetate) was also previously used as a treatment for uterine fibroids; however, the license for this has been suspended while a safety review is carried out due to rare but serious cases of liver injury, including hepatic failure requiring liver transplantation, being reported worldwide.

This development potentially inhibits the longer-term use of the treatment but it is still prescribed as an ‘as needed’ option for emergency contraception, with only one dose required.

The main concern is over how long this medication can be used safely by patients.

We will also need to wait for the US and EU to finalize their reviews and decide if it can be approved for use. Until these regulatory bodies decide what they're going to do we, sadly, will not be able to share if (and when!) this treatment will actually be available for PMDD patients.

Another source of hope here is that other drugs in the same class (that work in similar ways) are also under development, and some of these may have fewer safety concerns. Similar compounds may be developed that could be safer and work just as well-- this would take years but are a possibility for future treatment.

We are excited to follow the development of this approach, and we are hopeful that it could lead to new treatment options in the future.

Read about currently available evidence-based treatment options here:

Dr. Tory Eisenlohr-Moul, IAPMD Clinical Advisory Board Chair

Did this answer your question?