title: Evaluation of different add-back estradiol and progesterone treatments to gonadotropin-releasing hormone agonist treatment in patients with premenstrual dysphoric disorder.
abstract: OBJECTIVE
  The aim of this study was to investigate which add-back hormone replacement therapy would be most beneficial in terms of mood effects for patients with premenstrual dysphoric disorder who are receiving gonadotropin-releasing hormone agonist therapy.
  
  
  METHODS
  Three different add-back hormone replacement treatments were evaluated in a randomized, double-blinded, cross-over clinical trial in 27 patients premenstrual dysphoric disorder. The add-back treatments consisted of 1.5 mg estradiol and 400 mg progesterone, 1.5 mg estradiol and placebo, and 0.5 mg estradiol and 400 mg progesterone. The primary outcome measure was daily symptom ratings for mood and physical symptoms.
  
  
  RESULTS
  The highest dose of estradiol in combination with progesterone was associated with the most pronounced symptom recurrence, both in comparison with a lower dose of estradiol together with progesterone and estradiol-only treatment.
  
  
  CONCLUSIONS
  Based on the findings of the present study, long-cycle add-back treatment to avoid frequent progestagen use appears to be most beneficial for patients with premenstrual dysphoric disorder.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, University Hospital, Uppsala S-751 85, Sweden. birgitta.segeblad@lvn.se
authors.forename: Birgitta
authors.initials: B
authors.lastname: Segebladh
authors.forename: Anna
authors.initials: A
authors.lastname: Borgström
authors.forename: Sigrid
authors.initials: S
authors.lastname: Nyberg
authors.forename: Marie
authors.initials: M
authors.lastname: Bixo
authors.forename: Inger
authors.initials: I
authors.lastname: Sundström-Poromaa
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D001007:Anxiety / Q000188:drug therapy; D018592:Cross-Over Studies; D003863:Depression / Q000188:drug therapy; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects; D016729:Leuprolide / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy*; D010919:Placebos; D011293:Premenstrual Syndrome / Q000188:drug therapy*; D011374:Progesterone / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D010919:Placebos; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D016729:Leuprolide