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.
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
Topics
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