Exploring the Basis of Depression and Pain in Premenstrual Dysphoria Disorder from the Perspective of Estrogen Fluctuations

doi:10.12280/gjfckx.20240660

Abstract

Abstract:

Premenstrual dysphoria disorder (PMDD) is a common disease that endangers the health of women of childbearing age. with a high prevalence of suicidal tendencies in severe cases, and the sensitivity of ovarian steroid hormone fluctuations may be its core pathogenesis. In clinical practice, PMDD patients are plagued by both mental and physical symptoms, but previous studies have often focused on emotional changes such as depressive disorders, neglecting physical accompanying symptoms such as breast tenderness and migraine. Migraine itself is affected by fluctuations in female estrogen levels and exhibits different individual sensitivities, and the use of antidepressants in pain treatment can also be seen clinically. Previous studies have shown that depression pain may have a common pathological basis, and estrogen fluctuations regulate the pathological changes of both. This paper reviews the basis of depression-pain occurrence in PMDD from the perspective of estrogen fluctuations, in order to provide reference for exploring the core pathogenesis and promote the development of antidepressant pain comorbidity drugs.

Key words: Premenstrual dysphoria disorder, Depression, Pain, Estrogens, Calcitonin gene related peptide

GAO Ming-zhou, GAO Dong-mei, MA Feng-jun, ZHANG Ke-xin, ZHANG Hao. Exploring the Basis of Depression and Pain in Premenstrual Dysphoria Disorder from the Perspective of Estrogen Fluctuations[J]. Journal of International Obstetrics and Gynecology, 2024, 51(6): 703-706.

References 36

[1]	Takeda T. Premenstrual disorders: Premenstrual syndrome and premenstrual dysphoric disorder[J]. J Obstet Gynaecol Res, 2023, 49(2):510-518. doi: 10.1111/jog.15484.
[2]	Tiranini L, Nappi RE. Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome[J]. Fac Rev, 2022, 11:11. doi: 10.12703/r/11-11. pmid: 35574174
[3]	Prasad D, Wollenhaupt-Aguiar B, Kidd KN, et al. Suicidal Risk in Women with Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Systematic Review and Meta-Analysis[J]. J Womens Health(Larchmt), 2021, 30(12):1693-1707. doi: 10.1089/jwh.2021.0185.
[4]	Schiola A, Lowin J, Lindemann M, et al. The burden of moderate/severe premenstrual syndrome and premenstrual dysphoric disorder in a cohort of Latin American women[J]. Value Health, 2011, 14(5 Suppl 1):S93-S95. doi: 10.1016/j.jval.2011.05.008.
[5]	Gao M, Zhang H, Wang C, et al. Top 100 Cited Papers on Premenstrual Syndrome/Premenstrual Dysphoric Disorder: A Bibliometric Study[J]. Front Psychiatry, 2022, 13:936009. doi: 10.3389/fpsyt.2022.936009.
[6]	王飞. 经前期综合征中医证候、体质及人格的研究[D]. 天津: 天津中医药大学, 2022.
[7]	Freeman EW, Sammel MD, Lin H, et al. Clinical subtypes of premenstrual syndrome and responses to sertraline treatment[J]. Obstet Gynecol, 2011, 118(6):1293-1300. doi: 10.1097/AOG.0b013e318236edf2. pmid: 22105258
[8]	Halbreich U, O′Brien PM, Eriksson E, et al. Are there differential symptom profiles that improve in response to different pharmacological treatments of premenstrual syndrome/premenstrual dysphoric disorder?[J]. CNS Drugs, 2006, 20(7):523-547. doi: 10.2165/00023210-200620070-00001. pmid: 16800714
[9]	孙文君. 经前烦躁障碍症(PMDD)证候与亚型:理论研究与横断面流行病学调查[D]. 济南: 山东中医药大学, 2016.
[10]	梁晓琳, 甘照宇. 经前期综合征与双相障碍共病探讨[J]. 新医学, 2023, 54(7):470-474. doi: 10.3969/j.issn.0253-9802.2023.07.003.
[11]	羊璞, 粟胜勇, 李羚, 等. 疼痛抑郁共病动物模型及针刺作用机制研究进展[J]. 中国中西医结合杂志, 2023, 43(11):1401-1408. doi: 10.7661/j.cjim.20230423.045.
[12]	黄晨晨, 寇久社, 江振华, 等. 雌激素在疼痛调控中的作用机制[J]. 神经解剖学杂志, 2023, 39(6):723-727. doi: 10.16557/j.cnki.1000-7547.2023.06.017.
[13]	雷荣, 阙建宇, 孙琳琳, 等. 雌激素对抑郁障碍影响的研究进展[J]. 四川精神卫生, 2019, 32(5):473-476. doi: 10.11886/j.issn.1007-3256.2019.05.021.
[14]	Tonon AC, Ramos-Lima LF, Kuhathasan N, et al. Early Life Trauma, Emotion Dysregulation and Hormonal Sensitivity Across Female Reproductive Life Events[J]. Curr Psychiatry Rep, 2024, 26(10):530-542. doi: 10.1007/s11920-024-01527-y.
[15]	王杰琼, 张惠云. 经前期综合征肝气郁证猕猴模型血清性激素检测分析[J]. 中国现代医药杂志, 2008, 10(3):1-4. doi: 10.3969/j.issn.1672-9463.2008.03.001.
[16]	郭洵溢, 赵丹青, 贾春平, 等. 围产期孕妇抑郁与血清雌激素和脱氢表雄酮水平的相关性[J]. 贵州医科大学学报, 2020, 45(6):700-704. doi: 10.19367/j.cnki.2096-8388.2020.06.015.
[17]	陈琪. 产后抑郁症患者血清雌激素、孕激素水平变化的meta分析[D]. 汕头: 汕头大学, 2021.
[18]	孙婷. 雌激素在绝经期女性抑郁症中的作用及机制探讨[J]. 微循环学杂志, 2021, 31(3):72-75,85. doi: 10.3969/j.issn.1005-1740.2021.03.015.
[19]	Sun LH, Zhang WX, Xu Q, et al. Estrogen modulation of visceral pain[J]. J Zhejiang Univ Sci B, 2019, 20(8):628-636. doi: 10.1631/jzus.B1800582.
[20]	康玉莱, 李琼, 郭露, 等. 女性与偏头痛管理[J]. 中风与神经疾病杂志, 2023, 40(12):1084-1088. doi: 10.19845/j.cnki.zfysjjbzz.2023.0234.
[21]	张雨桐, 王姿雯, 杜佳蓉, 等. 雌激素参与慢性痛的性别差异[J]. 中国疼痛医学杂志, 2018, 24(7):536-541. doi: 10.3969/j.issn.1006-9852.2018.07.012.
[22]	Charles A, Pozo-Rosich P. Targeting calcitonin gene-related peptide: a new era in migraine therapy[J]. Lancet, 2019, 394(10210):1765-1774. doi: 10.1016/S0140-6736(19)32504-8. pmid: 31668411
[23]	焦晓翠. 卫星胶质细胞上容量激活氯电流的分子基础及其激活机制研究[D]. 石家庄: 河北医科大学, 2014. doi: 10.7666/d.Y2582133.
[24]	颜瑞. 抑郁症患者血清谷氨酸、γ-氨基丁酸的水平及其临床意义[J]. 国际精神病学杂志, 2022, 49(4):609-611.
[25]	Hantsoo L, Epperson CN. Allopregnanolone in premenstrual dysphoric disorder (PMDD): Evidence for dysregulated sensitivity to GABA-A receptor modulating neuroactive steroids across the menstrual cycle[J]. Neurobiol Stress, 2020, 12:100213. doi: 10.1016/j.ynstr.2020.100213.
[26]	Long J, Wang Y, Liu L, et al. The Prominent Role of the Temporal Lobe in Premenstrual Syndrome and Premenstrual Dysphoric Disorder: Evidence From Multimodal Neuroimaging[J]. Front Psychiatry, 2022, 13:954211. doi: 10.3389/fpsyt.2022.954211.
[27]	胡坤. 川芎白芍不同配比对偏头痛模型痛阈和三叉神经血管通路c-fos、pCREB的影响[D]. 北京: 北京中医药大学, 2018.
[28]	张俊蕊. 近十年中医治疗原发性三叉神经痛用药规律探讨[D]. 济南: 山东中医药大学, 2013.
[29]	王梓安, 刘超群, 张嘉宁, 等. 基于数据挖掘探究芳香中药治疗抑郁症的用药规律[J]. 中南药学, 2023, 21(6):1664-1669. doi: 10.7539/j.issn.1672-2981.2023.06.042.
[30]	朱鸿秋. 雌二醇导致经行头痛的实验及经轻胶囊干预机制初探[D]. 成都: 成都中医药大学, 2005. doi: 10.7666/d.y766005.
[31]	刘欢. 从肝主疏泄论治经前烦躁症—盐酸氟西汀治疗PMDD肝气逆、郁两证的疗效差异研究[D]. 济南: 山东中医药大学, 2017.
[32]	赵皎颖. 盐酸氟西汀治疗非典型性牙痛临床疗效评价[J]. 全科口腔医学电子杂志, 2020, 7(5):78.
[33]	甘国强, 薛莲. 腰椎间盘突出症模型大鼠的疼痛与抑郁共病情况及氟西汀疗效的实验研究[J]. 颈腰痛杂志, 2021, 42(3):365-368. doi: 10.3969/j.issn.1005-7234.2021.03.021.
[34]	张本骏, 张化彪, 李梦洋, 等. 醒脑止痛汤联合氟西汀治疗脑卒中后丘脑痛的临床疗效观察[J]. 实用中医内科杂志, 2022, 36(7):48-50. doi: 10.13729/j.issn.1671-7813.Z20211665.
[35]	安忠秋. 从肝主疏泄论治经前烦躁症—经前舒颗粒对比氟西汀治疗PMDD肝气郁证的疗效对比[D]. 济南: 山东中医药大学, 2016.
[36]	Zhang H, Qiao M, Gao D, et al. Shuyu capsule alleviates premenstrual depression via allopregnanolone metabolic pathway targeting GABA (A) receptors δ subunit in the hippocampus[J]. Asian J Psychiatr, 2023, 90:103800. doi: 10.1016/j.ajp.2023.103800.