Rapkin, A. J., Morgan, M., Goldman, L., Brann, D. W., Simone, D., & Mahesh, V. B. (1997). Progesterone metabolite allopregnanolone in women with premenstrual syndrome. Obstetrics and Gynecology, 90(5), 709-714. https://doi.org/10.1016/S0029-7844(97)00417-1
Rapkin AJ, Morgan M, Goldman L, Brann DW, Simone D, Mahesh VB. Progesterone metabolite allopregnanolone in women with premenstrual syndrome. Obstet Gynecol. 1997;90(5):709-714. doi:10.1016/S0029-7844(97)00417-1
Rapkin, A. J., et al. "Progesterone metabolite allopregnanolone in women with premenstrual syndrome." Obstetrics and Gynecology, vol. 90, no. 5, 1997, pp. 709-714.
Women with PMS had lower allopregnanolone late in the luteal phase
Women with PMS had lower allopregnanolone on day 26 than women without PMS. It is a calming byproduct of progesterone. The 1997 study compared 35 women with PMS and 36 controls. Their progesterone levels did not differ significantly.
Key Findings
Blood was drawn on days 19 and 26 of the cycle, timed with urinary LH detection kits, from 35 women with PMS and 36 controls.
Allopregnanolone was significantly lower in the PMS group than in controls on day 26. Absolute levels on day 19 were comparable between groups.
Across the two sampling days, the ratio of allopregnanolone to progesterone was significantly smaller in women with PMS. Serum progesterone did not differ significantly between the groups.
Women with PMS were significantly more symptomatic in the luteal phase. The two groups did not differ significantly in the follicular phase.
Interpretation
This study compared 35 women with PMS to 36 women without PMS. Blood draws on cycle days 19 and 26 were timed to ovulation with urinary LH kits. Women with PMS had lower allopregnanolone late in the luteal phase. Progesterone itself stayed the same between the groups, pointing to the byproduct as the source of the difference. The authors suggest lower allopregnanolone could add to mood symptoms of PMS, such as anxiety, tension, and depression. The findings support larger studies of this hormone's role in PMS.
RRM Context
Cycle timing carries this study. The team used urinary LH kits to time each blood draw and left out women who did not ovulate. The finding sits in the luteal phase, after ovulation. Restorative reproductive medicine treats PMS as a question about the ovulatory cycle. Progesterone itself was the same between groups. Its byproduct was the difference.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To evaluate the anxiolytic 3alpha-5alpha-reduced progesterone metabolite allopregnanolone in the luteal phase of the menstrual cycle in women with premenstrual syndrome (PMS) and controls.
Methods
Thirty-five women with prospectively documented PMS and 36 controls were evaluated. Serum progesterone and allopregnanolone levels were measured on days 19 and 26 of the cycle as determined by urinary LH detection kits. Analysis of variance and Student t tests were used to analyze the data.
Results
Allopregnanolone levels were significantly lower on day 26 in the PMS group than in controls (3.6 +/- 0.8 versus 7.5 +/- 1.3 ng/mL; P < .04). Significant differences in the ratio of the metabolite to progesterone also were noted, with a smaller ratio in the PMS subjects (0.9 +/- 0.3 versus 3.2 +/- 1.3 ng/mL; P < .05). There were no significant differences between the PMS and control groups with respect to serum progesterone levels.
Conclusion
Subjects with PMS manifested lower levels of the anxiolytic metabolite allopregnanolone in the luteal phase when compared with controls. Diminished concentrations of allopregnanolone in women with PMS may lead to an inability to enhance gamma aminobutyric acid-mediated inhibition during states of altered central nervous system excitability, such as ovulation or physiologic or psychological stress. The lowered metabolite levels could contribute to the genesis of various mood symptoms of the disorder, such as anxiety, tension, and depression.
