Role of Gonadal Steroids in MRMD

Abstract

We evaluated the efficacy of ovarian suppression with a GnRH agonist in the treatment of women with prospectively confirmed menstrual-related mood disorders (MRMD) during a double-blind, placebo-controlled, parallel design trial. All women (patients and controls) received either GnRH agonist (depot leuprolide acetate) or placebo (N saline) IM every four weeks for 24 weeks and received in random sequence estradiol and progesterone as “add back” hormones during the latter 12 weeks. ANOVA-R was employed to examine the effects of depot lupron in women with MRMD compared with placebo and compared to controls.ANOVA-R demonstrated significant improvements in MRMD symptoms after two months in the women receiving active depot lupron compared with symptoms at baseline and during placebo treatment. A reappearance of significant mood and behavioral symptoms was experienced by several women with MRMD, but none of the control women, during both estradiol and progesterone “add back” phases. We are presently attempting to determine whether the clinically significant mood and behavioral symptoms in women with MRMD during “add back” represents a re-emergence of typical symptom cyclicity or gonadal steroid-induced affective state changes.