Kampo Prescriptions for Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Secondary Analysis of Nationwide Survey by JSOG Women's Health Care Committee.

Abstract

Premenstrual syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) significantly impair women's quality of life. A survey of obstetricians and gynecologists showed that 19.5% of the doctors preferred Kampo medicine, including Tokishakuyakusan (TSS), Kamishoyosan (KSS), Keishibukuryogan (KBG), and Yokukansan (YKS), as the first-choice treatment for these conditions. We aimed to analyze the characteristics of each Kampo prescription. A secondary analysis was conducted on survey results from members of the Japan Society of Obstetrics and Gynecology collected from September to November 2021. Data from 1,259 respondents treating PMS/PMDD were analyzed. Our correspondence analysis plotted relationships among treatments, showing that Kampo prescriptions of TSS, KSS, KBG, and YKS were distributed similarly to oral contraceptives (OCPs), but different from selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and gonadotropin-releasing hormone analogs. Among the Kampo formulas, prescription YKS was the closest to SSRIs/SNRIs. Logistic regression analysis revealed that shorter physician experience (< 10 years, ≥ 10 and < 20 years) was associated with selecting prescriptions for TSS and KBG, whereas being a private practitioner was linked to selecting prescriptions for KSS and YKS (clinic vs. hospital OR: 1.57, 1.77; clinic vs. university OR: 1.53, 1.71). The prescription of YKS was also associated with choosing SSRIs/SNRIs (OR: 1.81), chasteberry (OR: 6.24), and other medications or supplements (OR: 2.41). Kampo prescriptions were strongly correlated with OCPs. Prescription TSS and KBG were likely chosen by less experienced practitioners, whereas prescription YKS was used by those more familiar with PMS/PMDD treatments, including SSRIs/SNRIs.