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Premenstrual Syndrome and Progesterone Suppositories

Niall Mackenzie, DPM, MA; Wendy M. Holton
JAMA. 1991;265(1):26. doi:10.1001/jama.1991.03460010026011.
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To the Editor.—  Freeman et al1, in their article "Ineffectiveness of Progesterone Suppository Treatment for Premenstrual Syndrome," state that the symptoms were not significantly improved by progesterone compared with placebo.Dalton2 has shown that, in 1096 patients, only 23% responded to a dose as low as 400 mg daily, 33% responded to a dose of 400 mg twice daily, and another 20% responded to 400 mg three times daily, with 46% of the sample requiring a dose higher than 400 mg of progesterone twice daily. Maddock et al3 noted the variation of content of the progesterone suppositories. When 14 different types of progesterone suppositories from the United States were analyzed, only one was within the 3% limit required by the Committee of Safety in Medicines in Britain, and six ranged between 57% and 34% of the stated content.Freeman et al make no mention of the patient's


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