Can probiotics and an antidepressant reduce severe PMS symptoms?

Composition of the microbiota and 19 faecal enzyme activities in 21 young women (age range 21-35 yrs) with severe premenstrual syndrome (PMS) and the effect of probiotics administration were studied. PMS consists in emotional, behavioural and physical symptoms that recur regularly during the second half of each menstrual cycle. Sixteen women were given a supplement of Lactobacillus acidophilus and Bifidobacterium bifidum three capsules daily for 2 mths to relieve the gastrointestinal symptoms (constipation, diarrhoea, and abdominal pain) plus an antidepressant drug SAMe (S-adenosyl-L-methionine), 800 mg twice daily for 2 wks before menstruation to control emotional symptoms; five women with PMS were treated with probiotics alone. Nine healthy young women were studied as controls. Faecal samples were collected on the 8th and 23rd days of the cycle before starting therapy, on the 23rd day of therapy and 1 mth after the end of therapy. Women with PMS showed low concentrations of both aerobes and anaerobes in comparison with the healthy controls. Following treatment aerobic lactobacilli increased ten-fold; L. acidophilus and B. bifidum were isolated in the majority of patients. Anaerobic gram-positive non-spore-forming rods increased in species number and frequency. During treatment a number of faecal enzymes (β-glucosidase, β-glucuronidase and alkaline phosphatase) achieved levels and frequencies comparable with those determined in healthy women. Moreover, relief of some PMS symptoms was noted in the majority of women studied reducing the severity of PMS from severe to mild. Bacteriotherapy induced partial restoration of the intestinal balance, but the effect was not maintained for very long after discontinuation of treatment. Keywords: premenstrual syndrome, Lactobacillus acidophilus, Bifidobacterium bifidum , faecal enzymes, microbiota, β-glucuronidase, S-adenosyl-L-methionine.

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