--- title: Does PMDD change blood flow in a brain area linked to mood, depending on hormones? description: Yes. In this small brain-imaging study, women with PMDD showed lower resting blood flow in a mood-related brain region when given estradiol or progesterone, w url: https://niyora.com/research/papers/subgenual-cingulate-resting-regional-cerebral-blood-flow-in-premenstrual-2021/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does PMDD change blood flow in a brain area linked to mood, depending on hormones? Survey study, 2021 # Does PMDD change blood flow in a brain area linked to mood, depending on hormones? Yes. In this small brain-imaging study, women with PMDD showed lower resting blood flow in a mood-related brain region when given estradiol or progesterone, while women without PMDD did not. Early gene data also hinted at a possible biological link, but this needs much more research. Early or limited evidence 20 women with PMDD and 43 healthy women, studied with repeated PET brain scans under controlled hormone conditions. ## What they did Researchers used PET brain scans to measure resting blood flow in 20 women with PMDD and 43 healthy women. Each woman had her own hormones suppressed with a drug, then was given estradiol and separately progesterone, so the same person could be compared across hormone states. They also looked at whether a set of hormone-related genes was linked to the blood flow changes in the PMDD group. ## What they found There was a significant diagnosis-by-hormone interaction in the subgenual cingulate (P=0.05). Women with PMDD had decreased resting blood flow in this area during both estradiol (P=0.02) and progesterone (P=0.0002) add-back, while control women showed no hormone-related change. In the PMDD group, gene expression correlated strongly with the blood flow change between the hormone-suppressed and progesterone conditions (r=-0.807, P=0.016). ## What it means for you This supports the idea that PMDD involves the brain responding abnormally to normal hormone levels, rather than abnormal hormone levels themselves. The study was very small (20 women with PMDD) and highly technical, so it points to possible future treatment targets rather than something usable today. 20 Women with PMDD scanned 0.0002 P-value, progesterone condition r=-0.807 Gene-blood flow correlation ## About the study Original title Subgenual cingulate resting regional cerebral blood flow in premenstrual dysphoric disorder: differential regulation by ovarian steroids and preliminary evidence for an association with expression of ESC/E(Z) complex genes Authors Wei SM, Baller EB, Martinez PE et al. Journal Translational psychiatry Year 2021 Study design Survey study Participants 43 What was tested Hormone manipulation (ovarian suppression, then estradiol add-back, then progesterone add-back) while measuring brain blood flow. Open access Yes Read the paper [doi.org/10.1038/s41398-021-01328-4](https://doi.org/10.1038/s41398-021-01328-4) Original abstract Substantial evidence suggests that circulating ovarian steroids modulate behavior differently in women with PMDD than in those without this condition. However, hormonal state-related abnormalities of neural functioning in PMDD remain to be better characterized. In addition, while altered neural function in PMDD likely co-exists with alterations in intrinsic cellular function, such a relationship has not been explored. Here, we investigated the effects of ovarian steroids on basal, resting regional cerebral blood flow (rCBF) in PMDD, and, in an exploratory analysis, we tested whether the rCBF findings were linked to the expression of ESC/E(Z) genes, which form an essential ovarian steroid-regulated gene-silencing complex. Resting rCBF was measured with oxygen-15 water PET (189 PET sessions in 43 healthy women and 20 women with PMDD) during three self-as-own-control conditions: GnRH agonist (Lupron)-induced ovarian suppression, estradiol add-back, and progesterone add-back. ESC/E(Z) gene expression data were obtained from RNA-sequencing of lymphoblastoid cell lines performed in a previous study and were examined in relation to hormone-induced changes in rCBF. In the rCBF PET data, there was a significant diagnosis-by-hormone interaction in the subgenual cingulate (P FDR = 0.05), an important neuroanatomical hub for regulating affective state. Whereas control women showed no hormonally-related changes in resting rCBF, those with PMDD showed decreased resting rCBF during both estradiol (P = 0.02) and progesterone (P = 0.0002) add-back conditions. In addition, in PMDD, ESC/E(Z) gene expression correlated with the change in resting rCBF between Lupron-alone and progesterone conditions (Pearson r = -0.807, P = 0.016). This work offers a formulation of PMDD that integrates behavioral, neural circuit, and cellular mechanisms, and may provide new targets for future therapeutic interventions. Reproduced under CC-BY. ## Topics [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/) 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 Systematic review, 2024 What are the best treatments for PMDD and PMS? Guideline, 2023 How are GnRH agonists used to treat PMDD that doesn't respond to standard medications? Review, 2022 What causes severe PMS and what treatments work? Systematic review, 2022 What are the best treatments for PMDD and PMS? Review, 2018 What are the most effective treatments for premenstrual syndrome and PMDD? Review, 2015 What do we know about PMS and PMDD and how are they treated? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗