Novel methods for detecting hormone sensitive affective dysregulation in regularly cycling women: A proof-of-concept...

Sensitivity to ovarian hormone changes is a proposed mechanism for perinatal depression. Previous studies investigated this pathway using a four to five-month hormone challenge protocol, in which estradiol and progesterone were administered to non-pregnant women during GnRH agonist-induced ovarian suppression. This scaled-down hormonal model of pregnancy induced affective symptoms in a subgroup of women, subsequently classified as hormone sensitive (HS+). However, to conduct future biomarker studies at scale, there is a need to determine hormone sensitivity (HS) status using simplified, less invasive methods. The current proof-of-concept study thus examines the feasibility of two approaches: 1) an abbreviated, seven-day hormone challenge protocol without ovarian suppression (n = 9), and 2) prospective assessment of menstrually-related mood disorders (MRMD) (n = 14).

Participants who underwent a four-month hormone challenge protocol were invited to participate in the follow-up study. The brief hormone challenge protocol consisted of seven days of combined estradiol (E2) and progesterone (P4) and seven days of placebo, administered in a double-blind crossover manner. HS+ was defined as a 30 % or greater increase in affective symptoms during the E2/P4 condition. MRMD was determined using the Carolina Premenstrual Assessment Scoring System.

HS classifications in the four-month protocol were replicated by the seven-day hormone challenge (p = .028). HS status related to MRMD at the level of a trend (p = .066).

Limitations include a small sample size due to recruitment from an earlier study cohort and stringent exclusion criteria; therefore, results are exploratory and require replication.

Results provide proof-of-concept that a brief hormone challenge can identify HS+ individuals.