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In clinical practice, leuprolide is occasionally used for women with severe, treatment-refractory premenstrual dysphoric disorder (PMDD). Because long-term ovarian suppression with leuprolide induces a hypogonadal state, add-back hormonal therapy (low-dose estrogen with or without progestin) may later be introduced to mitigate bone loss and vasomotor symptoms. However, when these hormones are reintroduced, PMDD symptoms may recur.
In this study, 49 women with PMDD and 76 without received monthly injections of leuprolide alone for 3 months. Those with PMDD who had symptom remission on leuprolide — and all of those without PMDD — then added either estrogen or progesterone for 5 weeks, followed by a 2-week washout period and then a switc…