PMS

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Dr. Charles Butrick:  “Jim, I understand that there’s been a lot of advancement in our understanding of some of the premenstrual problems women suffer with - the problems of anxiety, loss of control, depression, and crying that sometimes can be exactly tied to the menstrual cycle.  Can you tell me really what PMS is?  Is it a hormone imbalance?  What’s wrong with these women?”

Dr. James Carter:  “Let me start with your first comment, there have been some remarkable developments.  The FDA has actually approved Sarafem, which is Eli Lilly’s product for the treatment of premenstrual dysphoric disorder.  Sarafem is a medication, which is dedicated to the treatment of premenstrual dysphoric disorder.  Now what is premenstrual dysphoric disorder – some women will develop what we call ‘premenstrual syndrome’ which is symptoms of anxiety, depression, bloating, breast tenderness, and feeling out of sorts during the second half of their cycle.  We believe this is related to progesterone and estrogen secretion but in relationship to the brain tissue and to serotonin levels.  It turns out that Sarafem is what we call a ‘serotonin reuptake inhibitor,’ and a serotonin reuptake inhibitor can actually treat those symptoms but we use it for those women where the PMS becomes premenstrual dysphoric disorder.  So what’s the difference – the difference is premenstrual dysphoric disorder causes interference with the person’s life.  They can’t work, they can’t study, their inner personal relationships get affected, in fact, it’s more than PMS - it’s gotten to the point where they can’t live their life properly.  There are two advantages to this, as you know, one is breast tenderness, which is very difficult to treat as well as bloating and in fact this medication reduces symptoms of both the physical symptoms of breast tenderness and bloating during that second half of the cycle.  So besides all the anxiety reduction, the depression reduction, the improvement in their feelings, and the improvement in their inner personal relations, we get some physical benefits for those patients too.”

Dr. Charles Butrick:  “Is this a medication that patients have to take all the time?”

Dr. James Carter:  “They can take it in a low dosage all the time or at the same dosage only two weeks of each month, which I have found works fine if they start it with their time of ovulation and take it up to the first day of their cycle.  It does reduce their symptoms so they can take it intermittently or all the time.  I found it worked very well.” 

Dr. Charles Butrick:  “Are there a lot of side effects with this new treatment?”

Dr. James Carter:  “Extremely minimal and it starts working reasonably soon so there are very few side effects.  It’s long tested, it’s a very good medication, and my patients have really appreciated it.  If people contact Eli Lilly, they can get information on this.  They can also contact their physician about this medication because it is newly approved by the FDA for this disorder.”

Dr. Charles Butrick:  “That’s really exciting, Jim.”

Dr. James Carter:  “It is; it’s very exciting.”

Dr. Charles Butrick:  “Thank you.”

Dr. James Carter:  “Thank you very much.”