Objective: This study investigated whether women with premenstrual dysphoric disorder (PMDD) who also had histories of sexual abuse differed from women with PMDD with no previous sexual abuse and from women without PMDD in hypothalamic-pituitary-thyroid (axis measures).
Methods: Ten sexually abused women with PMDD were compared with 18 nonabused women with PMDD and 22 nonabused women without PMDD for hypothalamic-pituitary-thyroid axis hormone concentrations during the follicular and luteal phases of confirmed ovulatory cycles.
Results: Compared with the women without PMDD, only the group of women with PMDD with sexual abuse showed greater variance in both cycle phases in thyroid-stimulating hormone concentrations and greater luteal phase variance in free and total thyroxine (T4) and reverse tri-iodothyronine (T3). In the group of nonabused women with PMDD, there was greater variance in follicular phase thyroxine-binding globulin concentrations compared with the group without PMDD. Women with PMDD with abuse had greater mean concentrations of total T3 and thyroxine-binding globulin, greater total T3/free T4 and free T3/free T4 ratios, and lower ratios of free T3/total T3 and free T4/total T4 than either of the other 2 nonabused groups. Greater total T3 concentrations and histories of major depression independently predicted premenstrual symptoms in all women with PMDD, together accounting for 31% to 38% of the variance in anxiety, anger, and depression ratings.
Conclusions: These results suggest increased conversion of T4 to T3 and increased binding of thyroid hormones in women with PMDD with previous sexual abuse. Abnormal total T3 concentrations may have pathophysiological significance in PMDD.