定期的なサイクルを持つ女性におけるホルモン感受性情動調節不全の検出法：概念実証研究

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 and progesterone 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.