Premenstrual syndrome and related hormonal changes. Long-acting gonadotropin releasing hormone agonist treatment

The results of long-acting, injectible gonadotropin releasing hormone agonist (GnRH-a) and placebo treatment of severe premenstrual syndrome (PMS) patients with regular menstrual cycles and without known psychiatric disorders are reported. Diagnosis was made according to the Menstrual Symptom Questionnaire and Menstrual Symptom Diary scores. In a placebo-controlled, crossover study, 12 subjects were given either normal saline or depot leuprolide acetate (7.5 mg) every 30 days, starting with the onset of menses. Each subject received the same agent twice before switching to the other and did not known which agent was given. A significant decrease in PMS symptoms was reported by all subjects in both treatment regimens. Biweekly venous blood sampling showed significant elevations of beta-endorphin levels and suppression of gonadotropin concentrations in subjects receiving depot leuprolide treatment. Short-term treatment of severe PMS with an injectible, long-acting GnRH-a may not treat the disease more than do saline injections in a group of women selected by certain criteria.