---
title: Are PMDD symptoms triggered by changes in hormone levels or by having high hormone levels?
description: PMDD symptoms are triggered by the rapid increase in hormone levels after ovulation, not by having those hormones at steady high levels. Once hormone levels s
url: https://niyora.com/research/papers/premenstrual-dysphoric-disorder-symptoms-following-ovarian-suppression-triggered-2017/
---

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- Are PMDD symptoms triggered by changes in hormone levels or by having high hormone levels?

Case-control study, 2017

# Are PMDD symptoms triggered by changes in hormone levels or by having high hormone levels?

PMDD symptoms are triggered by the rapid increase in hormone levels after ovulation, not by having those hormones at steady high levels. Once hormone levels stay stable, symptoms improve.

 Moderate study design

22 women with PMDD ages 30-50 years (12 completed the full study)

## What they did

Researchers studied 22 women with PMDD ages 30 to 50. The 12 women whose symptoms went away during ovarian suppression with leuprolide then received 1 month of placebo and 3 months of continuous combined estradiol and progesterone. Symptoms were tracked every 2 weeks during clinic visits.

## What they found

Symptoms were significantly worse during the first month of adding hormones compared to the last month of ovarian suppression, the placebo month, and months 2 and 3 of continuous hormones. There were no significant differences between the suppression period, placebo month, and months 2-3 of continuous hormones.

## What it means for you

The rapid change from low to high hormone levels (as happens naturally after ovulation) triggers symptoms, not the high levels themselves. This could lead to new treatments that prevent these rapid changes. The limitation is the small sample of 12 women completing the full study.

22

women with PMDD

12

who had symptom remission and completed hormone phase

3

months of continuous hormone treatment

## About the study

Original title Premenstrual Dysphoric Disorder Symptoms Following Ovarian Suppression: Triggered by Change in Ovarian Steroid Levels But Not Continuous Stable Levels Authors Schmidt PJ, Martinez PE, Nieman LK et al. Journal The American journal of psychiatry Year 2017 Study design Case-control study Participants 22 What was tested Leuprolide ovarian suppression, then placebo and continuous estradiol/progesterone Open access Yes Read the paper [doi.org/10.1176/appi.ajp.2017.16101113](https://doi.org/10.1176/appi.ajp.2017.16101113)

## 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/)[Anxiety and tension](https://niyora.com/research/topics/symptom-anxiety/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/)

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