Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome.

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

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 ...