Lower insulin-like growth factor-1 concentrations in women with premenstrual dysphoric disorder

Recent evidence suggests that abnormalities in calcium metabolism may be responsible for the luteal phase symptoms in women experiencing premenstrual syndrome. Our objective was to measure the cyclic variations in bone turnover across the menstrual cycle in women with and without luteal phase symptoms consistent with severe premenstrual syndrome or premenstrual dysphoric disorder.

We measured the indices of bone metabolism, N-telopeptide, osteocalcin and insulin-like growth factor-1 in women with and without premenstrual dysphoric disorder using a cross-sectional and prospective design. Participating women underwent 2 months of self-assessment symptom screening and 1 month of hormonal evaluation.

Overall serum insulin-like growth factor-1 (mean +/- standard deviation) was significantly lower in the premenstrual dysphoric disorder group compared with controls (205.7 +/- 56.8 vs 240.2 +/- 76.9 ng/ mL, P = .01) and was significantly lower throughout all 5 phases of the menstrual cycle in the premenstrual dysphoric disorder group compared with controls. In both groups of women, serum insulin-like growth factor-1 concentrations were highest and urinary N-telopeptide levels were lowest during the luteal phase. Bone remodeling indices of formation and resorption during the menstrual cycle were greater and appeared earlier in the control compared with the premenstrual dysphoric disorder group.

Significantly lower insulin-like growth factor-1 concentrations in premenstrual dysphoric disorder subjects compared with controls may hold insights about how premenstrual dysphoric disorder subjects differ from asymptomatic controls.