Women´s mental health: Serotonin and steroids

Mood and anxiety disorders largely affect mental health in a profound sex- and hormone-dependent manner, not only in terms of symptoms occurrence and prevalence, but likely also regarding the biological underpinnings, nature, course, and treatment outcome. The menstrual cycle can cause general discomfort and affect women´s mood.

Most women, of reproductive age, experience mild symptoms, but among 3-5 percent, the hormonal changes can lead to disabling mental symptoms, known as premenstrual dysphoric disorder (PMDD). PMDD, likewise depression and anxiety disorders, is characterized by emotional distress and dysregulation. All three are treated with serotonergic antidepressants, however efficacy in PMDD is almost immediate.

Notably, the neuromolecular substrates of this extraordinary efficacy are not know, thus hampering our understanding of the disorder.

The herein proposed randomized, placebo controlled study will profile candidate molecular substrates in the brain and blood of women with Premenstrual Dysphoric Disorder receiving a selective serotonin reuptake inhibitor (SSRI) or placebo.

To understand the neurobiological basis of PMDD is key to the development of preventive and treatment strategies for this disorder as well as of premenstrual exacerbation of psychiatric symptoms of other disorders.

The herein proposed study – for the first time – will allow to gain insight into the neuromolecular substrates of PMDD and the relief of its symptoms from a mechanistic angle.