Gonadotropin-associated psychosis in perimenstrual behavior disorder.
Sexually provocative and violent behavior have been reported as a result of excess androgens. We now report a temporal relationship between increased gonadotropin levels and behavioral changes in two adolescent girls who presented with a history of aggressive and bizarre sexual behavior coincident with the onset of menarche. We evaluated the possibility of a cyclical hormonal cause with daily measurements of gonadotropins, androgens and estradiol levels and correlated the results with periodic reports on the girls' behavior. We concluded that a correlation exists between periods of extremely violent and sexually provocative behavior and peaks of gonadotropin hormone secretion, even though androgen levels were normal. Treatment with medroxyprogesterone acetate (Depo-Provera) in one case and with leuprolide acetate (Lupron-Depot) in the other suppressed gonadotropin levels, and behavior improved markedly. Thus, the behavioral changes (or psychosis) seen in these girls might have been induced by increased levels of gonadotropins.
Constant
M
M
Department of Pediatrics, Schneider Children's Hospital, Long Island Jewish Medical Center, New York, N.Y.
Abrams
C A
CA
Chasalow
F I
FI
D002648:Child; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D007986:Luteinizing Hormone / Q000378:metabolism*; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008572:Menarche; D008598:Menstruation / Q000502:physiology*; D011618:Psychotic Disorders / Q000097:blood* / Q000188:drug therapy; D012725:Sexual Behavior / Q000523:psychology
D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D017258:Medroxyprogesterone Acetate; D016729:Leuprolide