Case report, 2023

Can stopping ovulation help severe PMDD when other treatments do not work?

Yes. In this case, a woman with severe PMDD symptoms had improvement when treated with leuprorelin acetate and full resolution after surgery to remove her ovaries. This is a single case of very severe PMDD.

Early or limited evidence 1 multiparous woman in her mid-30s with severe PMDD

What they did

A woman in her mid-30s with severe PMDD that did not respond to oral contraceptive pills or antidepressants was treated with leuprorelin acetate, a medication that stops ovulation. When symptoms improved but were not fully resolved, she had surgery to remove both ovaries and started hormone replacement therapy.

What they found

Her PMDD symptoms improved with the medication and completely resolved after the ovary removal surgery. She then continued hormone replacement therapy.

What it means for you

For women with severe PMDD that does not respond to standard treatments, stopping ovulation might help. This is only one case, and the surgery is major and permanent, so it is only an option for the most severe cases. PMDD has multiple causes and may respond differently to different treatments.

18%

of women experience PMS symptoms

3-8%

of women meet PMDD criteria

woman in this case

About the study

Original title: The multifactorial aetiology and management of premenstrual dysphoric disorder with leuprorelin acetate
Authors: Dunphy L, Boyle S, Wood F
Journal: BMJ case reports
Year: 2023
Study design: Case report
What was tested: Leuprorelin acetate, then bilateral oophorectomy and hormone replacement therapy
Open access: Yes
Read the paper: doi.org/10.1136/bcr-2023-258343

Topics

Premenstrual syndrome (PMS)Premenstrual dysphoric disorder (PMDD)Menstrual cycle and mood Low mood and depression SSRIs and antidepressants Oral contraceptives and drospirenone GnRH agonists and ovarian suppression Estradiol, progesterone and hormone therapy Surgical menopause Major depressive disorder Quality of life and daily functioning

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