--- title: Do estrogen and progesterone each trigger PMDD symptoms differently? description: Yes, likely. Both hormones triggered mood symptoms in women with PMDD when reintroduced after suppression, but progesterone appeared more closely linked to ir url: https://niyora.com/research/papers/differential-effects-of-ovarian-steroids-in-women-with-and-without-premenstrual-2025/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Do estrogen and progesterone each trigger PMDD symptoms differently? Cohort study, 2025 # Do estrogen and progesterone each trigger PMDD symptoms differently? Yes, likely. Both hormones triggered mood symptoms in women with PMDD when reintroduced after suppression, but progesterone appeared more closely linked to irritability and mood swings than estrogen. Moderate study design 34 women with PMDD and 76 healthy women ## What they did Cohort study of 34 women with PMDD and 76 healthy women. Participants received leuprolide injections for 12 weeks to suppress ovarian hormones, eliminating the normal menstrual cycle. Then estrogen was added back for 4 weeks, followed by progesterone added back for 4 weeks. Women completed daily symptom rating forms throughout all phases. ## What they found When estrogen or progesterone were reintroduced, women with PMDD showed significant increases in anxiety, sadness, irritability, and mood swings compared with hormone suppression alone. Healthy women did not show these increases during hormone addback. Women with PMDD had significantly higher symptom scores during both estrogen and progesterone addback compared to healthy women. Irritability and mood swings were more closely tied to progesterone than estrogen in PMDD. Bloating and food cravings were worse in women with PMDD across all hormone conditions. Breast pain increased during estrogen addback but not during progesterone. ## What it means for you This study suggests PMDD involves abnormal brain sensitivity to estrogen and progesterone rather than abnormal hormone levels. Suppressing hormones eliminated symptoms; reintroducing them brought symptoms back. Progesterone may be more important for mood symptoms than estrogen. The sample was small and findings need confirmation in larger studies. 34 women with PMDD 76 healthy comparison women 12 weeks duration of hormone suppression ## About the study Original title Differential Effects of Ovarian Steroids in Women With and Without Premenstrual Dysphoric Disorder: A Replication and Extension of Findings Authors Wei SM, Wakim P, Martinez PE et al. Journal The American journal of psychiatry Year 2025 Study design Cohort study Participants 76 What was tested Hormone suppression with leuprolide, then estrogen added back, then progesterone added back Read the paper [doi.org/10.1176/appi.ajp.20240596](https://doi.org/10.1176/appi.ajp.20240596) ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Irritability and anger](https://niyora.com/research/topics/symptom-irritability-anger/)[Mood swings and emotion regulation](https://niyora.com/research/topics/symptom-emotional-regulation/)[Bloating, breast tenderness and physical symptoms](https://niyora.com/research/topics/symptom-physical-symptoms/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/) 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, 2007 Does paroxetine work better if taken daily or just during your luteal phase for PMDD? Randomised trial, 2003 What treatments work for PMS and PMDD? Study, 2026 What are premenstrual syndrome and premenstrual dysphoric disorder? Survey study, 2025 How common is PMDD in Brazilian women and what are the most frequent symptoms? Study, 2025 Do women with PMDD who experienced childhood trauma have more trouble recognizing emotions? Cohort study, 2023 Does the menstrual cycle affect how often women have suicidal thoughts? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗