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Volume 338:209-216 January 22, 1998 Number 4 Next

	Full Text PDF Editorial by Mortola, J. F. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The symptoms of women with premenstrual syndrome improve in response to suppression of ovarian function, although these women have no evidence of ovarian dysfunction. We undertook a study to determine the role of estrogen and progesterone in this syndrome.

Methods We first studied the effect of ovarian suppression with leuprolide, an agonist analogue of gonadotropin-releasing hormone, or placebo on symptoms in 20 women with premenstrual syndrome. Ten women whose symptoms improved during leuprolide treatment were given estradiol and progesterone in a double-blind, crossover design, each for four weeks, during continued leuprolide administration. Women without premenstrual syndrome (normal women) participated in a similar protocol. Outcomes were assessed on the basis of daily self-reports by the patients and biweekly rater-administered symptom-rating scales.

Results The 10 women with premenstrual syndrome who were given leuprolide had a significant decrease in symptoms as compared with base-line values and with values for the 10 women who were given placebo. The 10 women with premenstrual syndrome who were given leuprolide plus estradiol or progesterone had a significant recurrence of symptoms, but no changes in mood occurred in 15 normal women who received the same regimen or in 5 women with premenstrual syndrome who were given placebo hormone during continued leuprolide administration.

Conclusions In women with premenstrual syndrome, the occurrence of symptoms represents an abnormal response to normal hormonal changes.

Source Information

From the Behavioral Endocrinology Branch, National Institute of Mental Health (P.J.S., L.F.A., D.R.R.); the Developmental Endocrinology Branch, National Institute of Child Health and Human Development (L.K.N.); and the Clinical Center Nursing Department (M.A.D.) — all at the National Institutes of Health in Bethesda, Md.

Address reprint requests to Dr. Schmidt at the National Institute of Mental Health, Bldg. 10, Rm. 3N238, 10 Center Dr. MSC 1276, Bethesda, MD 20892-1276.

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