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. 2017 Aug 8;7(8):e1193. doi: 10.1038/tp.2017.146

Table 5. Changes in steroid metabolites during ovarian steroid replacement of P4.

Metabolite Median Δ
 P-value
 Q-value
  PMDD NC PMDD NC PMDD NC
Progesterone 7850 8530 6.10E−05 6.10E−05 0.001 0.001
3a-Hydroxy-5a-pregnan-20-one 344 318 1.22E−04 6.10E−05 0.001 0.001
Pregnanediol 342 506 0.010 0.005 0.077 0.030
DHEAS* −91 935 159 968 0.018 0.048 0.104 0.157
Cortexone 31 31 0.026 0.041 0.118 0.157
2-Hydroxyestrone −5.4 −10.7 0.060 0.135 0.183# 0.387
Estradiol-3-SO4 −26 −12 0.064 0.649 0.183# 0.727
Cortexolone 69 0 0.064 0.727 0.183# 0.727
Androstenedione −101 123 0.252 0.035 0.447 0.157#
17a,20a-Dihydroxyprogesterone 13 40 0.599 0.002 0.726 0.015#

Abbreviations: DHEA, dehydroepiandrosterone; Median Δ, median change; NC, normal control; P4, progesterone; PMDD, premenstrual dysphoric disorder.

The unit of measurement for all steroid metabolites is pg ml−1.

This table shows the significant changes in steroid levels in women with PMDD and controls with P4 addback relative to Lupron. Significant differences indicated by Q<0.2.

Only DHEAS levels showed significant between-group differences following P4 treatment (*P=0.003; q=0.073), decreasing in women with PMDD treated with P4 but increasing in control women subjected to the same hormonal treatment. Direct comparisons of other P4-related changes in steroid levels between PMDD and control women did not reach significance.

Within diagnostic groups, we observed trend effects of hormone condition in the magnitude of the change in steroid metabolite levels from Lupron to P4 in PMDD but not controls, as follows: 2-hydroxyestrone (median Δ: PMDD=−5.4 pg ml−1 (decreased), #q=0.183; controls=−10.7 pg ml−1, q=0.387), estradiol-3-SO4 (median Δ: PMDD=−26 pg ml−1(decreased), #q=0.183; controls=−12 pg ml−1, q=0.727) and cortexolone (median Δ: PMDD=69 pg ml−1, #q=0.183; controls=0 pg ml−1, q=0.727). In addition, we also observed significant effects of hormone condition in the magnitude of the change in steroid metabolite levels from Lupron to P4 in controls but not in PMDD, as follows: 17a, 20a-dihydroxyprogesterone (median Δ: PMDD=13 pg ml−1, q=0.726; controls=40 pg ml−1, #q=0.015) and androstenedione (median Δ: PMDD=−101 pg ml−1(decreased), q=0.447; controls=123 pg ml−1, #q=0.157).