DIFFERENTIAL BEHAVIORAL-EFFECTS OF GONADAL-STEROIDS IN WOMEN WITH ANDIN THOSE WITHOUT PREMENSTRUAL-SYNDROME

Background The symptoms of women with premenstrual syndrome improve in response to suppression of ovarian function, although these women hav e no evidence of ovarian dysfunction. We undertook a study to determin e the role of estrogen and progesterone in this syndrome. Methods We f irst studied the effect of ovarian suppression with leuprolide, an ago nist analogue of gonadotropin-releasing hormone, or placebo on symptom s in 20 women with premenstrual syndrome. Ten women whose symptoms imp roved during leuprolide treatment were given estradiol and progesteron e in a double-blind, crossover design, each for four weeks, during con tinued leuprolide administration. Women without premenstrual syndrome (normal women) participated in a similar protocol. Outcomes were asses sed on the basis of daily self-reports by the patients and biweekly ra ter-administered symptom-rating scales. Results The 10 women with prem enstrual 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 syndr ome who were given leuprolide plus estradiol or progesterone had a sig nificant recurrence of symptoms, but no changes in mood occurred in 15 normal women who received the same regimen or in 5 women with premens trual syndrome who were given placebo hormone during continued leuprol ide administration. Conclusions In women with premenstrual syndrome, t he occurrence of symptoms represents an abnormal response to normal ho rmonal changes. (C) 1998, Massachusetts Medical Society.