--- title: Is a lower dose of estradiol patch as effective as a higher dose for severe PMS? description: Yes. The lower 100 microgram dose was equally effective as 200 micrograms but better tolerated with fewer side effects and less dropout. url: https://niyora.com/research/papers/a-randomised-comparison-over-8-months-of-100-micrograms-and-200-micrograms-twice-1995/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Is a lower dose of estradiol patch as effective as a higher dose for severe PMS? Randomised trial, 1995 # Is a lower dose of estradiol patch as effective as a higher dose for severe PMS? Yes. The lower 100 microgram dose was equally effective as 200 micrograms but better tolerated with fewer side effects and less dropout. Strong study design Women with severe PMS ## What they did This was an 8-month randomized controlled trial comparing two doses of transdermal estradiol. Women were assigned to either 100 or 200 micrograms of Estraderm TTS (an estradiol skin patch) applied twice weekly continuously, combined with a progestin (either dydrogesterone 10 mg or medroxyprogesterone acetate 5 mg) given from day 17 to day 26 of each cycle. ## What they found Both doses reduced symptoms equally and showed no significant difference in the primary symptom score. The higher dose group had a significantly higher dropout rate and more side effects attributed to estrogen. Satisfaction with treatment was 45% to 57% at 8 months. The 100 microgram dose produced a mean blood estradiol level of 300 pmol/l while the 200 microgram dose produced 573 pmol/l. The 100 microgram dose suppressed midluteal progesterone from a mean of 35.5 to 3.4, confirming it stops ovulation. ## What it means for you Lower-dose estradiol patches are just as effective as higher doses but are better tolerated with fewer dropouts. Both doses suppress ovulation and prevent the hormonal cycle that triggers PMS. However, less than half of women were satisfied, suggesting estradiol works for some but not all. 8 months Trial duration 45-57% Satisfaction rate at 8 months 100 or 200 mcg Estradiol patch doses ## About the study Original title A randomised comparison over 8 months of 100 micrograms and 200 micrograms twice weekly doses of transdermal oestradiol in the treatment of severe premenstrual syndrome Authors Smith RN, Studd JW, Zamblera D et al. Journal British journal of obstetrics and gynaecology Year 1995 Study design Randomised trial What was tested Estraderm TTS at 100 or 200 micrograms twice weekly, each combined with a progestin Read the paper [doi.org/10.1111/j.1471-0528.1995.tb11321.x](https://doi.org/10.1111/j.1471-0528.1995.tb11321.x) ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2023 What hormonal treatments have been tested for PMDD, menstrual migraine, and catamenial epilepsy? Survey study, 2022 What causes PMS and PMDD and what new treatments are being studied? Systematic review, 2015 What are the effects of continuous hormonal treatments for premenstrual syndrome? Review, 2012 How should premenstrual disorders be diagnosed and organized? Review, 2012 How is PMS diagnosed and treated, especially in women approaching menopause? Randomised trial, 2012 Do hysterectomy or hormonal IUDs reduce premenstrual symptoms in women with heavy periods? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗