A landmark study by US-based National Institutes of Health (NIH) researchers has established the biological cause for why women get irritable, sad and even suicidal during the days leading up to their menstrual period. Premenstrual dysphoric disorder (PMDD) is a mood disorder that affects two to five per cent of women of reproductive age. It is a much severe form of premenstrual syndrome (PMS). Major symptoms of PMDD are irritability, sadness, depression and anxiety in the days leading up to menstrual period. These symptoms are so severe that they can actually stop women from living their regular life. Some women feel depressed to the point of suicide, says lead author Dr Neelima Dubey, a Pune-based researcher with the National Centre for Cell Science (NCCS).
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Dubey got the opportunity to work on this project when she was a postdoctoral fellow at NIH.
The study has been published in January 3 edition of Molecular Psychiatry, a journal, and holds hope for improved treatment for such mood disorders, said Dubey. “These findings are very important as it is the first evidence for the abnormal cellular signaling in women with PMDD. Now, we know that women with the disease cannot voluntarily control their emotional behaviour. We have demonstrated, for the first time, that PMDD is not just in the head of women, but it has a plausible biological basis,” said Dubey.
Researchers have shown that women with PMDD are more sensitive to the change of sex hormones — estrogen and progesterone — during their menstrual cycle. They found that turning off estrogen and progesterone eliminated PMDD symptoms, while re-introducing the hormones triggered the re-emergence of symptoms. Hence, PMDD is a disorder of cellular response to estrogen and progesterone.
Using disease in a dish approach, scientists have also provided evidence of abnormal signaling in cells derived from PMDD patients, and a plausible biological cause for their abnormal behavioural-sensitivity to estrogen and progesterone. The study identified dysregulation of ESC/E(Z) (Extra Sex Combs/Enhancer of Zeste) gene complex that acts differently in women, with the disorder compared to women without it. Researchers found that more than half of the ESC/E(Z) complex genes are over-expressed in women suffering with PMDD.
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 behaviour they can control, said Dr Anjali Shiras, Scientist at NCCS. Following this NIH study, researchers at NCCS are now planning to develop cell lines from the blood of Indian women diagnosed with such disorders.