Effects of combined oral contraception containing drospirenone on premenstrual exacerbation of Meniere's disease: Preliminary study

Objectives: Meniere's disease is caused by an augmented endolymph pressure in the inner ear; symptoms are vertigo, fluctuating hearing loss and tinnitus. Exacerbations has been noted during premenstrual phase. The study aims to evaluate the effects of a 20 μm Ethinylestradiol (EE) and 3 mg Drospirenone (DRSP) oral contraceptive (20 μmEE/3mgDRSP) in continuous regimen, associated with rehabilitation therapy on Meniere's disease. Study design: This non-randomized controlled study was performed from October 2015 to October 2017. Forty-two premenopausal women affected by MD with severe distress in the premenstrual phase were enrolled. Sixteen women constituted the study group (Group A), and twenty women constituted the control group (Group B). Group A underwent EE/DRSP therapy and rehabilitation and Group B underwent rehabilitation therapy alone. Stabilometry and the Dizziness Handicap Inventory questionnaire were used to measure vestibular function and distress related to the disease, respectively, at baseline (T0), 3 months (T1) and 6 months (T2). Results: At T0, both groups had large, similar areas of stabilometric ellipses (p = NS) that reduced more in Group A than in Group B, at T1 and T2 (p < 0.001). High scores of the DHI (cut-off ≤54) were observed at T0 in both groups (A 66.8 ± 2.8 vs B 65.5 ± 3.6; p = NS). At T1, a gradual improvement in both groups was observed, manly in Group A (A 45.1 ± 3.6 vs B 62.4 ± 4.1; p < 0.001). At T2, the DHI scores were significantly lower in Group A (39.2 ± 3.8) compared to Group B (68.8 ± 3.6) (p < 0.001). Conclusions: DRSP could be effective in reducing the fluid overload typical of the premenstrual phase, improving symptoms of MD. The results support the efficacy of EE/DRSP usage associated with rehabilitation therapy on premenstrual exacerbation of MD.