--- title: Does blocking progesterone receptors help women with PMDD control anger and aggression? description: Yes, according to this study. Women taking the medication had a 93% response rate compared with 53.3% on placebo, and their brains showed stronger activity in url: https://niyora.com/research/papers/brain-reactivity-during-aggressive-response-in-women-with-premenstrual-dysphoric-2021/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does blocking progesterone receptors help women with PMDD control anger and aggression? Randomised trial, 2021 # Does blocking progesterone receptors help women with PMDD control anger and aggression? Yes, according to this study. Women taking the medication had a 93% response rate compared with 53.3% on placebo, and their brains showed stronger activity in emotion control regions. Moderate study design 30 women with PMDD ## What they did 30 women with PMDD received either a selective progesterone receptor modulator (SPRM) or placebo. They had brain imaging scans while performing a task designed to measure aggressive responses. Researchers measured symptoms and hormone levels. ## What they found The SPRM treatment group had a 93% response rate compared to 53.3% in the placebo group. Brain scans showed women on SPRM had enhanced activity in regions associated with emotion regulation (the dorsal anterior cingulate cortex and dorsomedial prefrontal cortex) when responding to aggression. The relationship between brain activity and actual aggressiveness differed between the groups. ## What it means for you This suggests blocking progesterone receptors may help PMDD by strengthening the brain's emotion control circuits. However, this was a very small study with only 30 women, and it only measured one type of brain response, so the findings need to be tested in larger groups before we know if this works as a treatment. 30 Women in study 93% Response rate with treatment 53.3% Response rate with placebo ## About the study Original title Brain reactivity during aggressive response in women with premenstrual dysphoric disorder treated with a selective progesterone receptor modulator Authors Kaltsouni E, Fisher PM, Dubol M et al. Journal Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology Year 2021 Study design Randomised trial Participants 30 What was tested Selective progesterone receptor modulator (SPRM) Open access Yes Read the paper [doi.org/10.1038/s41386-021-01010-9](https://doi.org/10.1038/s41386-021-01010-9) Original abstract Premenstrual dysphoric disorder (PMDD) is a psychiatric condition characterized by late luteal phase affective, cognitive, and physical impairment. The disorder causes significant suffering in about 5% of women in their reproductive age. Altered sensitivity of cognitive-affective brain circuits to progesterone and its downstream metabolite allopregnanolone is suggested to underlie PMDD symptomatology. Core mood symptoms include irritability and anger, with aggression being the behavioral outcome of these symptoms. The present study sought to investigate the neural correlates of reactive aggression during the premenstrual phase in women with PMDD, randomized to a selective progesterone receptor modulator (SPRM) or placebo. Self-reports on the Daily Record of Severity of Problems were used to assess PMDD symptoms and gonadal hormone levels were measured by liquid chromatography tandem mass spectrometry. Functional magnetic resonance imaging was performed in 30 women with PMDD, while performing the point subtraction aggression paradigm. Overall, a high SPRM treatment response rate was attained (93%), in comparison with placebo (53.3%). Women with PMDD randomized to SPRM treatment had enhanced brain reactivity in the dorsal anterior cingulate cortex and dorsomedial prefrontal cortex during the aggressive response condition. The fronto-cingulate reactivity during aggressive responses depended on treatment, with a negative relationship between brain reactivity and task-related aggressiveness found in the placebo but not the SPRM group. The findings contribute to define the role of progesterone in PMDD symptomatology, suggesting a beneficial effect of progesterone receptor antagonism, and consequent anovulation, on top-down emotion regulation, i.e., greater fronto-cingulate activity in response to provocation stimuli. Reproduced under CC-BY. ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Irritability and anger](https://niyora.com/research/topics/symptom-irritability-anger/)[Cognition, concentration and memory](https://niyora.com/research/topics/symptom-cognition/)[Neurosteroids (allopregnanolone)](https://niyora.com/research/topics/treatment-neurosteroids/)[Pregnancy and postpartum](https://niyora.com/research/topics/comorbidity-postpartum/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Randomised trial, 2018 How do progesterone metabolites affect PMDD symptoms? Review, 2003 How do menstrual cycle hormones affect the brain and cause mood disorders like PMDD? Randomised trial, 2017 Does Sepranolone reduce symptoms of severe premenstrual syndrome (PMDD)? Review, 2015 Does a progesterone metabolite called allopregnanolone cause mood problems in PMDD? Randomised trial, 2023 Does a smartphone app for heart rate variability biofeedback reduce premenstrual and depressive symptoms? Randomised trial, 2016 Does blocking progesterone conversion help PMDD symptoms? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗