Women who suffer an intense form of PMS can now blame their genes

A severe form of premenstrual syndrome known as PMDD (premenstrual dysphoric disorder) has a specific biological cause, according to research published in the journal Molecular Psychiatry.

The study, by the National Institutes of Health (NIH) in the US, reveals the molecular mechanisms that are responsible for a woman’s susceptibility to disabling irritability, sadness, and anxiety in the days leading up to menstruation.

PMDD affects between two and five per cent of women of reproductive age, whereas less severe PMS is much more common.

Peter Schmidt, the study’s lead author, said: ‘We found dysregulated expression in a suspect gene complex which adds to evidence that PMDD is a disorder of cellular response to oestrogen and progesterone. Learning more about the role of this gene complex holds hope for improved treatment of such prevalent reproductive endocrine-related mood disorders.

‘This is a big moment for women’s health, because it establishes that women with PMDD have an intrinsic difference in their molecular apparatus for response to sex hormones — not just emotional behaviours they should be able to voluntarily control.’

In the 1990s, NIH researchers confirmed that women with PMDD have a biologically based behavioural sensitivity to levels of the hormones oestrogen and progesterone.

Now they have identified a gene structure called ESC/E(Z) (extra sex combs/Enhancer of zeste) which regulates epigenetic mechanisms that govern the transcription of genes into proteins in response to the environment. This gene was found to be over-expressed in PMDD patients’ cells, compared to those taken from control subjects.

‘For the first time, we now have cellular evidence of abnormal signalling in cells derived from women with PMDD, and a plausible biological cause for their abnormal behavioural sensitivity to oestrogen and progesterone,’ Schmidt said.

Instant analysis
Premenstrual dysphoric disorder (PMDD) is an intense type of premenstrual syndrome and can affect between two and five per cent of women of reproductive age. Symptoms are similar to PMS but more pronounced and so can include extreme anger, depression, lethargy, low self-esteem and severe irritability.

This research now suggests that PMDD appears to be a disorder of the body’s cell response to the hormones oestrogen and progesterone. This is important as it shows that PMDD sufferers have an intrinsic difference in how they respond to sex hormones, and not just problems with emotional behaviour that they could control themselves.

Interesting as this is, it is likely to be many years before this translates into any kind of therapeutic pathway for PMDD sufferers and so remains of limited value clinically at present with much more research needing to be done here.
RH
Research score: 2/5