Calcium versus oral contraceptive pills containing drospirenone for the treatment of mild to moderate premenstrual syndrome: a double blind randomized placebo controlled trial

ObjectiveTo compare the efficacy of calcium supplements versus combined oral contraceptive pills (COC) containing drospirenone in treating mild to moderate premenstrual syndrome.Study DesignThis was a double-blind, randomized placebo controlled trial conducted in Beni-Suef University Hospital. Premenstrual syndrome (PMS) was prospectively diagnosed using the Daily Record of Severity of Problems (DRSP). In total, 210 women with mild to moderate PMS were randomly divided into three equal groups. Group 1 received COC daily for 21 days starting on the third day of menstruation and a daily oral placebo similar to calcium and vitamin D. Group 2 received calcium 400 mg + vitamin D 400 IU once daily and an oral placebo similar to COC for 21 days starting on the third day of menstruation. Group 3 received a daily placebo similar to calcium and vitamin D in addition to an oral placebo similar to COC for 21 days starting on the third day of menstruation. Treatment was continued for 3 months.ResultsThe proportion of women with improved PMS decreased progressively from the COC group to the calcium group and the placebo group (81%, 62.3% and 16.3%, respectively; p < 0.001). Similarly, mean DRSP scores 5 days before menstruation decreased progressively from the COC group, the calcium group and the placebo group (45.51 ± 16.97, 55 ± 15.71 and 74.98 ± 19.12, respectively; p < 0.001).ConclusionBoth COC and calcium supplements improved DRSP scores in women with mild to moderate PMS, but the improvement was more evident with COC.