Cited by 767Menstrual Health and DisordersOvarian function and disordersMenopause: Health Impacts and Treatments

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Differential Behavioral Effects of Gonadal Steroids in Women with and in Those without Premenstrual Syndrome

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Schmidt, Peter J., Nieman, Lynnette K., Danaceau, Merry A., Adams, Linda F., Rubinow, David R.·1998·New England Journal of Medicine

DOI 10.1056/nejm199801223380401

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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 the 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.

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Authors: Schmidt, P. J., Nieman, L. K., Danaceau, M. A., Adams, L. F., & Rubinow, D. R.
Affiliations: National Institutes of Health (US)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
National Institute of Mental Health (US)
ORCID: Schmidt, Peter J.
Nieman, Lynnette K.
Rubinow, David R.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1998-01-22
Volume: 338
Issue: 4
Pages: 209-216
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm199801223380401
OpenAlex: W2046110224
Cited by: 765
References: 28
Citations by year: 2026: 30 · 2025: 38 · 2024: 26 · 2023: 27 · 2022: 31 · 2021: 28 · 2020: 21 · 2019: 24 · 2018: 24 · 2017: 26 · 2016: 32 · 2015: 23 · 2014: 24 · 2013: 31 · 2012: 31
FWCI: 29.44
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: Upsher-Smith
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: premenstrual syndrome, premenstrual dysphoric disorder, leuprolide, GnRH agonist, ovarian suppression, estradiol, progesterone, estrogen, symptom recurrence
MeSH terms: Adult, Double-Blind Method, Emotions, Estradiol, Female, Humans, Gonadotropin-Releasing Hormone, Middle Aged, Premenstrual Syndrome, Progesterone, Leuprolide, Cross-Over Studies, Hot Flashes

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Differential Behavioral Effects of Gonadal Steroids in Women with and in Those without Premenstrual Syndrome

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