Advertisement

Vitamin D Supplementation for Premenstrual Syndrome-Related Mood Disorders in Adolescents with Severe Hypovitaminosis D

Published:December 24, 2015DOI:https://doi.org/10.1016/j.jpag.2015.12.006

      Abstract

      Study Objective

      Premenstrual syndrome (PMS) might become severe enough to interfere with normal interpersonal relationships. This study was planned to assess whether administration of vitamin D (200,000 IU at first, followed by 25,000 IU every 2 weeks) for a 4-month period might lessen the appearance and the intensity of mood disorders associated with PMS in young girls with severe hypovitaminosis D.

      Design, Setting, Participants, Interventions, and Main Outcome Measures

      One hundred fifty-eight young girls (15-21 years old) with PMS-related severe symptoms of the emotional and cognitive domains and low serum 25-hydroxycholecalciferol (25-OH-D) levels (≤10 ng/mL) were randomly assigned to two treatment groups and treated for 4 months with vitamin D (group 1; n = 80) or placebo (group 2; n = 78). Clinical and hormonal effects were compared between the two groups.

      Results

      In patients from group 1, levels of vitamin D reached the normal range (35-60 ng/mL) after the first month and remained stable throughout the whole study. At the end of treatment, anxiety score decreased from 51 to 20 (P < .001 vs baseline); irritability score declined from 130 to 70 (P < .001 vs baseline). Crying easily and sadness decreased by a score of 41 and 51 to a score of 30 and 31, respectively (P < .001). For disturbed relationships, the score decreased from 150 to 70 (P < .001). Conversely, no appreciable changes were noted in symptom intensity from patients of group 2. The frequency of adverse events (nausea and constipation) was not different between participants of group 1 and group 2.

      Conclusion

      On the basis of the present findings, vitamin D therapy can be proposed as a safe, effective, and convenient method for improving the quality of life in young women with severe hypovitaminosis D and concomitant mood disorders associated with PMS.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric and Adolescent Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Braverman P.K.
        Premenstrual syndrome and premenstrual dysphoric disorder.
        J Pediatr Adolesc Gynecol. 2007; 20: 3
        • Halbreich U.
        The diagnosis of premenstrual syndromes and premenstrual dysphoric disorder–clinical procedures and research perspectives.
        Gynecol Endocrinol. 2004; 19: 320
      1. American College of Obstetricians and Gynecologists: Premenstrual syndrome. ACOG Practice Bulletin 2000; 15.

        • Mortola J.F.
        Issues in the diagnosis and research of premenstrual syndrome.
        Clin Obstet Gynecol. 1992; 35: 587
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders.
        4th ed. American Psychiatric Association, Washington, DC1994
        • Steiner M.
        • Streiner D.L.
        • Steinberg S.
        • et al.
        The measurement of premenstrual mood symptoms.
        J Affect Disord. 1999; 53: 269
        • Freeman E.W.
        Premenstrual syndrome and premenstrual dysphoric disorder: definitions and diagnosis.
        Psychoneuroendocrinology. 2003; 28: 25
        • Halbreich U.
        • O'Brien P.M.
        • Eriksson E.
        • et al.
        Are there differential symptom profiles that improve in response to different pharmacological treatments of premenstrual syndrome/premenstrual dysphoric disorder?.
        CNS Drugs. 2006; 20: 523
        • Mortola J.F.
        Premenstrual syndrome–pathophysiologic considerations.
        N Engl J Med. 1998; 338: 256
        • Johnson S.R.
        Premenstrual syndrome, premenstrual dysphoric disorder, and beyond: a clinical primer for practitioners.
        Obstet Gynecol. 2004; 104: 845
        • Steiner M.
        • Pearlstein T.
        • Cohen L.S.
        • et al.
        Expert guidelines for the treatment of severe PMS, PMDD, and comorbidities: the role of SSRIs.
        J Womens Health (Larchmt). 2006; 15: 57
        • Yonkers K.A.
        • Pearlstein T.B.
        • Gotman N.
        A pilot study to compare fluoxetine, calcium, and placebo in the treatment of premenstrual syndrome.
        J Clin Psychopharmacol. 2013; 33: 614
        • De Berardis D.
        • Serroni N.
        • Salerno R.M.
        • et al.
        Treatment of premenstrual dysphoric disorder (PMDD) with a novel formulation of drospirenone and ethinyl estradiol.
        Ther Clin Risk Manag. 2007; 3: 585
        • Hoffmann V.
        • Pedersen P.A.
        • Philip J.
        • et al.
        The effect of dydrogesterone on premenstrual symptoms. A double-blind, randomized, placebo-controlled study in general practice.
        Scand J Prim Health Care. 1988; 6: 179
        • Holick M.F.
        • Vitamin D.
        a D-Lightful health perspective.
        Nutr Rev. 2008; 66: S182
        • Holick M.F.
        Does vitamin D3 dosing schedule influence treatment efficacy in nursing home residents with vitamin D deficiency?.
        Nat Clin Pract Endocrinol Metab. 2008; 4: 656
        • Holick M.F.
        The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action.
        Mol Aspects Med. 2008; 29: 361
        • Holick M.F.
        Vitamin D status: measurement, interpretation, and clinical application.
        Ann Epidemiol. 2009; 19: 73
        • Holick M.F.
        • Biancuzzo R.M.
        • Chen T.C.
        • et al.
        Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D.
        J Clin Endocrinol Metab. 2008; 93: 677
        • Khajehei M.
        • Abdali K.
        • Parsanezhad M.E.
        • et al.
        Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome.
        Int J Gynaecol Obstet. 2009; 105: 158
        • Li G.
        • Mbuagbaw L.
        • Samaan Z.
        • et al.
        Efficacy of vitamin D supplementation in depression in adults: a systematic review protocol.
        Syst Rev. 2013; 2: 64
        • Stumpf W.E.
        • Privette T.H.
        Light, vitamin D and psychiatry. Role of 1,25 dihydroxyvitamin D3 (soltriol) in etiology and therapy of seasonal affective disorder and other mental processes.
        Psychopharmacology (Berl). 1989; 97: 285
        • Thys-Jacobs S.
        • Alvir M.J.
        Calcium-regulating hormones across the menstrual cycle: evidence of a secondary hyperparathyroidism in women with PMS.
        J Clin Endocrinol Metab. 1995; 80: 2227
        • Vichnin M.
        • Freeman E.W.
        • Lin H.
        • et al.
        Premenstrual syndrome (PMS) in adolescents: severity and impairment.
        J Pediatr Adolesc Gynecol. 2006; 19: 397
        • Stewart A.
        • Wong K.
        • Cachat J.
        • et al.
        Neurosteroid vitamin D system as a nontraditional drug target in neuropsychopharmacology.
        Behav Pharmacol. 2010; 21: 420
        • Groves N.J.
        • McGrath J.J.
        • Burne T.H.
        Vitamin D as a neurosteroid affecting the developing and adult brain.
        Annu Rev Nutr. 2014; 34: 117
        • Eyles D.W.
        • Smith S.
        • Kinobe R.
        • et al.
        Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain.
        J Chem Neuroanat. 2005; 29: 21
        • Stumpf W.E.
        Whole-body and microscopic autoradiography to determine tissue distribution of biopharmaceuticals – target discoveries with receptor micro-autoradiography engendered new concepts and therapies for vitamin D.
        Adv Drug Deliv Rev. 2013; 65: 1086
        • Bertone-Johnson E.R.
        Vitamin D and the occurrence of depression: causal association or circumstantial evidence?.
        Nutr Rev. 2009; 67: 481
        • Harms L.R.
        • Burne T.H.
        • Eyles D.W.
        • et al.
        Vitamin D and the brain.
        Best Pract Res Clin Endocrinol Metab. 2011; 25: 657
        • Garcion E.
        • Wion-Barbot N.
        • Montero-Menei C.N.
        • et al.
        New clues about vitamin D functions in the nervous system.
        Trends Endocrinol Metab. 2002; 13: 100
        • Yonkers K.A.
        Management strategies for PMS/PMDD.
        J Fam Pract. 2004; : S15
        • Hoogendijk W.J.
        • Lips P.
        • Dik M.G.
        • et al.
        Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults.
        Arch Gen Psychiatry. 2008; 65: 508
        • Shaffer J.A.
        • Edmondson D.
        • Wasson L.T.
        • et al.
        Vitamin D supplementation for depressive symptoms: a systematic review and meta-analysis of randomized controlled trials.
        Psychosom Med. 2014; 76: 190
        • Bertone-Johnson E.R.
        • Hankinson S.E.
        • Bendich A.
        • et al.
        Calcium and vitamin D intake and risk of incident premenstrual syndrome.
        Arch Intern Med. 2005; 165: 1246
        • Bertone-Johnson E.R.
        • Chocano-Bedoya P.O.
        • Zagarins S.E.
        • et al.
        Dietary vitamin D intake, 25-hydroxyvitamin D3 levels and premenstrual syndrome in a college-aged population.
        J Steroid Biochem Mol Biol. 2010; 121: 434
        • Lee S.J.
        • Kanis J.A.
        An association between osteoporosis and premenstrual symptoms and postmenopausal symptoms.
        Bone Miner. 1994; 24: 127
        • Thys-Jacobs S.
        • Starkey P.
        • Bernstein D.
        • et al.
        Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group.
        Am J Obstet Gynecol. 1998; 179: 444
        • Thys-Jacobs S.
        Micronutrients and the premenstrual syndrome: the case for calcium.
        J Am Coll Nutr. 2000; 19: 220