Elimination of ovulation and menstrual cyclicity (with danazol) improves dysphoric premenstrual syndromes

Objective: To assess whether the therapeutic effect of danazol on premenstrual syndromes (PMS) is associated with suppression of ovulation. Design: After 1 month on placebo, we administered 200 mg/d of danazol for 90 days to 24 women with dysphoric PMS. Symptoms during ovulatory cycles were compared with anovulatory periods. Setting: Outpatient PMS program in a general hospital. Patients: Twenty-four women who had dysphoric PMS and otherwise were physically and mentally healthy. Interventions: None (except the oral medication). Main Outcome Measure: Prospective daily monitoring of symptoms with the Daily Rating Form, before, during, and after treatment. Results: Twenty of 23 anovulatory periods were symptom-free versus 6 of 32 ovulatory periods (x² = 15.63, P = 0.0002). Conclusion: The beneficial effect of danazol as treatment depends mostly on achieving an anovulatory state and elimination of hormonal cyclicity and not on the drug per se.