Recently, scientists at the Cochrane Review did a careful review of clinical trials of estrogen treatment in PMS/PMDD. They found that, based on a small trial, oral estrogen given in the luteal phase of the menstrual cycle is probably ineffective for PMS/PMDD. However, they report that other studies supported the effectiveness of continuous estrogen (in the form of transdermal patches or subcutaneous implants) plus cyclical progestin for part of the month (the same progesterone-like substances that are in birth control pills). While this might be encouraging evidence, the authors noted that they were concerned about the safety of the treatment long-term, since estrogen alone (or without enough progesterone addback) can increase the risk of estrogen-dependent cancers in the breast and uterus. Whenever you are taking hormones, be sure to work with a physician who has expertise in hormone therapies and is able to monitor any related risks. Usually, this is a gynecologist or a psychiatrist who specializes in women’s mental health.

-Tory Eisenlohr-Moul, PhD, August 20, 2019