Dutasteride for PMDD?Four Small-Trial Checks

Dutasteride’s PMDD research tested experimental regimens in very small groups.

Count the participants and treated cycles

Two sequential crossover experiments each included eight women with prospectively confirmed PMDD and eight controls. Participants took either 0.5 mg or 2.5 mg daily for one menstrual cycle, plus placebo. The dose groups were separate, without randomized comparison between doses. These were experimental regimens.¹

Identify the symptom result

The lower dose showed no significant core-symptom benefit. With 2.5 mg, premenstrual-versus-postmenstrual differences in irritability, sadness and anxiety improved. Six of eight participants no longer met PMDD criteria that cycle. This does not establish lasting remission; late-premenstrual anxiety considered alone was not significantly reduced.¹

Check the placebo comparison

Dutasteride persists for weeks. For participants receiving it first, researchers used the earlier single-blind placebo cycle for comparison to avoid carryover. That complicates interpretation. NIMH funded the work; GSK supplied medication.¹

Separate the experiment from current care

The US Avodart label covers enlarged-prostate symptoms in men, and says it is not indicated for women. PMDD use is unapproved. Pregnancy is contraindicated because of potential harm to a male fetus. Women who are pregnant or could be pregnant should not handle the capsules; wash skin with soap and water after contact with leaking contents. The label’s blood-donation restriction applies to treated men: no donation until at least six months after their last dose. It is not a pregnancy-planning schedule for women.²

For a treatment appointment, bring the study citation and ask: “How does this compare with approved treatments for my symptoms and pregnancy plans?” The Office on Women’s Health³ lists SSRIs and a drospirenone/ethinyl estradiol pill among approved PMDD treatments. It also recommends a symptom calendar or diary to help diagnosis.³ Our PMDD overview explains the diagnostic conversation.

Period, Handled includes a Period Scorecard for bleeding, pain interference and tiredness. It is not a PMDD diagnostic diary. Keep daily mood ratings separately, including days when symptoms ease, and bring both records if bleeding and mood need discussion. See the book.