Randomised trial, 1991
Does hormone replacement prevent GnRH agonist side effects in severe PMS?
Yes. GnRH agonist alone improved symptoms 75 percent. Adding estrogen and progesterone together maintained this improvement while avoiding hormone deficiency side effects.
What they did
An 8-month study of 8 women with severe PMS. First 2 months were baseline. Then 2 months of GnRH agonist (a hormone treatment stopping ovulation). Then 4 months testing hormone replacements while continuing GnRH agonist, in random order, double-blind: estrogen alone, progesterone alone, both together, and placebo, each for 1 month. Mood and physical symptoms were measured daily.
What they found
GnRH agonist alone resulted in 75 percent improvement in luteal phase symptom scores compared to baseline. When estrogen and progesterone were added together with GnRH agonist, there was 60 percent improvement compared to control months. This was as good as GnRH agonist alone and much better than adding estrogen alone, progesterone alone, or placebo.
What it means for you
For severe PMS, stopping ovulation with GnRH agonist works very well but causes hormone deficiency problems. Adding back both estrogen and progesterone together solves this problem while keeping the symptom improvement. The main limit is that this was a very small study of only 8 women.
8
women studied
75%
symptom improvement with GnRH agonist alone
60%
symptom improvement with hormone replacement added
About the study
- Original title
- Successful treatment of severe premenstrual syndrome by combined use of gonadotropin-releasing hormone agonist and estrogen/progestin
- Authors
- Mortola JF, Girton L, Fischer U
- Journal
- The Journal of clinical endocrinology and metabolism
- Year
- 1991
- Study design
- Randomised trial
- What was tested
- GnRH agonist with sequential estrogen and progestin replacement
- Read the paper
- doi.org/10.1210/jcem-72-2-252
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