Intended for healthcare professionals

Views And Reviews No Holds Barred

Margaret McCartney: We should stop fuelling anxiety

BMJ 2018; 361 doi: (Published 04 June 2018) Cite this as: BMJ 2018;361:k2399

Fuelling Anxiety with progestogens and oestrogens Re: Margaret McCartney: We should stop fuelling anxiety

Fuelling Anxiety with progestogens and oestrogens

I agree with Margaret Mc Cartney that posters in GP surgeries, pharmacies, researchers, charities and health promotions should stop fuelling anxiety.1 However, anxiety is often due to biochemical changes caused by common GP prescriptions.

A dramatic example of anxiety is the premenstrual syndrome (PMS) when some women can suddenly experience severe anxiety.2 Women affected can rush around cleaning everything in sight or become aggressive and argumentative. They are also more likely to have traffic accidents and deaths from violence. Biochemically, levels of the enzyme monoamine oxidase (MAO) increase dramatically from as low 1000 to as high as 20 000 units for a few days only at the end of a normal cycle in the premenstrual phase.3,4 When women are prescribed progesterone dominant hormonal contraceptives, or combined HRT, MOA levels can remain high, especially with modern continuous formulations, increasing the risk of accidental deaths or suicides.3,5,6

Women are more likely to suffer from PMS or exogenous hormone mental effects if they also have abnormal zinc/copper ratios and/or red blood cell (RBC) magnesium deficiencies.7 Magnesium is known as “Nature’s Calmer”. Both men and women can have difficulty correcting cellular magnesium deficiency if it is due to too much exercise or malabsorption problems. GPs and hospitals could have RBC tests available as serum magnesium levels are often in the normal range and not helpful in this context.

1 McCartney M. We should stop fuelling anxiety. BMJ 2018;361:k2399.
2 Greene R, Dalton K. The premenstrual syndrome. BMJ1953;1:1007-1014.
3 Grant ECG, Pryce Davies J. Effect of oral contraceptives on depressive mood changes and on endometrial monoamine oxidase and phosphatases. BMJ 1968;3:777-80.
4 Southgate J, Grant ECG, Pollard W, Pryse Davies J, Sandler M. Cyclical variations in endometrial monoamine oxidase: Correlations of histochemical and quantitative biochemical assays. Biochemical Pharmacology 1968;17:21-26.
5 Grant ECG. The influence of hormones on headache and mood in women. Hemicrania 1975;6:2-10.
6 Price EH. Increased risk of mental illness and suicide in oral contraceptive and hormone replacement therapy studies. J Nutr Environ Med 1998;8:121-128.
7 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity, and mineral imbalance. J Nutr Environ Med 1998;8:105-116.

Competing interests: No competing interests

05 June 2018
Ellen C Grant
Physician and medical gynaecologist
Kingston-upon-Thames. UK