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Action of Progesterone and Progesterone Metabolites in Menstrual‐Cycle–Related Disorders
Author(s) -
SundströmPoromaa Inger
Publication year - 2008
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2008.01201.x
Subject(s) - allopregnanolone , neuroactive steroid , anxiolytic , premenstrual dysphoric disorder , medicine , endocrinology , luteal phase , pregnanolone , gabaa receptor , menstrual cycle , anticonvulsant , sedative , irritability , psychology , pharmacology , neuroscience , epilepsy , receptor , hormone , menopause
Progesterone and progesterone metabolites are important modulators of central nervous system function through their interactions with the γ‐aminobutyric acid (GABA) A receptor. GABA, neurosteroids, and other modulators of GABA A , such as benzodiazepines, barbiturates, and alcohol, typically inhibit neuronal excitability. The resulting anxiolytic, anticonvulsant, sedative, and anesthetic effects are involved in mood, response to stress, and cognition. The impact of neurosteroids has been demonstrated in women with premenstrual dysphoric disorder: onset of negative mood symptoms has been correlated with peak progesterone levels, and symptoms intensified with progesterone withdrawal in the late luteal phase of the menstrual cycle. These symptoms were not present during anovulatory cycles without the corpus luteum, the primary source of progesterone and metabolites. The focus of this article is the paradox of why high levels of progesterone and neurosteroids, which typically are associated with anxiolytic activity, instead induce irritability, anxiety, and mood fluctuations in women with premenstrual dysphoric disorder.