---
title: Which hormone add-back therapy works best with GnRH agonist for PMDD?
description: The lowest dose of estradiol with progesterone worked better. The highest dose (1.5mg estradiol with 400mg progesterone) actually caused more symptom recurren
url: https://niyora.com/research/papers/evaluation-of-different-add-back-estradiol-and-progesterone-treatments-to-2009/
---

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- Which hormone add-back therapy works best with GnRH agonist for PMDD?

Randomised trial, 2009

# Which hormone add-back therapy works best with GnRH agonist for PMDD?

The lowest dose of estradiol with progesterone worked better. The highest dose (1.5mg estradiol with 400mg progesterone) actually caused more symptom recurrence than lower doses or estradiol alone.

 Moderate study design

27 women with premenstrual dysphoric disorder

## What they did

27 women with PMDD in a randomized double-blind cross-over trial tested three different hormone combinations: 1.5mg estradiol with 400mg progesterone, 1.5mg estradiol with placebo, and 0.5mg estradiol with 400mg progesterone. Daily symptom ratings measured mood and physical symptoms.

## What they found

The highest dose of estradiol combined with progesterone (1.5mg estradiol plus 400mg progesterone) caused the most symptom recurrence compared with lower-dose estradiol plus progesterone and estradiol alone.

## What it means for you

For women on GnRH agonists with PMDD, lower hormone doses spaced out over longer cycles may prevent more symptoms than high doses. However, this was a small study with only 27 women.

27

women studied

1.5 mg

highest estradiol dose tested

400 mg

progesterone dose

## About the study

Original title Evaluation of different add-back estradiol and progesterone treatments to gonadotropin-releasing hormone agonist treatment in patients with premenstrual dysphoric disorder Authors Segebladh B, Borgström A, Nyberg S et al. Journal American journal of obstetrics and gynecology Year 2009 Study design Randomised trial Participants 27 What was tested Three different hormone add-back regimens with GnRH agonist Open access Yes Read the paper [doi.org/10.1016/j.ajog.2009.03.016](https://doi.org/10.1016/j.ajog.2009.03.016)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/)

Research tells you what helps on average. Niyora helps on the day it hits.

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