Early- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder.

Yen Yen,Liu Liu,Ko Ko,Long Long,Lin Lin

doi:10.3390/ijerph16224352

Abstract

Objective/introduction: The dynamics of ovarian hormone fluctuations during the luteal phase of the menstruation cycle were previously suggested to contribute to the development of premenstrual dysphoric disorder (PMDD) symptoms, but adequate empirical evidence has not been obtained from hormone concentration studies. We prospectively evaluated estrogen and progesterone levels in the early luteal (EL) and late luteal (LL) phases in women with PMDD and the association of these levels with PMDD symptom severity. Methods: 63 women with PMDD and 53 controls without such severe symptoms were evaluated for the estrogen and progesterone levels, and PMDD severity in the EL and LL phases. Results: The results demonstrated that the women with PMDD had a lower EL-phase estrogen level than the controls. Covariant analysis demonstrated that the interaction term between EL-phase estrogen and EL-phase progesterone level was associated with PMDD severity. Among women with lower EL estrogen levels, higher EL-phase progesterone was observed among the women with PMDD versus controls. These results suggest that low EL-phase estrogen level could moderate the provoking effect of EL progesterone in women with PMDD. Overall, these data suggest a possible role of estrogen and progesterone in the development of PMDD symptoms.

Highlights

Premenstrual dysphoric disorder (PMDD) is listed as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
Because early luteal (EL)-phase estrogen was the hormone most strongly associated with premenstrual dysphoric disorder (PMDD) and was associated with EL progesterone in this study, we evaluated the effects of EL-phase estrogen and progesterone levels on LL-phase PMDD severity using the univariate general linear model (GLM)
The results repeatedly demonstrated that EL-phase progesterone level and the interaction term were significantly associated with PMDD severity

Summary

Introduction

Premenstrual dysphoric disorder (PMDD) is listed as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). A previous review suggested that the prevalence of PMDD ranges from 1.2% to 6.4% [1]. Women with PMDD experience predictable and cyclic psychological, behavioral, and somatic symptoms that are aggravated approximately 6 days during the late luteal (LL) phase, are improved after the onset of menses, and reoccur throughout most of the reproductive years [2,3,4]. The LL onset of PMDD symptoms suggests that fluctuating ovarian hormones play a role in its mechanism [5]. Res. Public Health 2019, 16, 4352; doi:10.3390/ijerph16224352 www.mdpi.com/journal/ijerph

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