Rapkin A J, Shoupe D, Reading A, Daneshgar K K, Goldman L, Bohn Y, Brann D W, Mahesh V B
Department of Obstetrics and Gynecology, UCLA School of Medicine 90024-1740, USA.
J Soc Gynecol Investig. 1996 Mar-Apr;3(2):93-8. doi: 10.1016/1071-5576(95)00045-3.
To evaluate central opioid activity in women with prospectively documented premenstrual syndrome (PMS) and control women in the mid- and late luteal phases of the menstrual cycle.
Blood was collected every 15 minutes 1 hour before (0800) and 2 hours after treatment (0900-1100). The treatment was administered in a randomized fashion and consisted of naloxone 1 or 4 mg or placebo, and blood was assayed for luteinizing hormone (LH). Baseline estradiol, progesterone, and prolactin were measured at 0800 and 0900 hours.
There was a significant increase in LH area under the curve and mean LH in response to naloxone in the midluteal phase in the control (P < .001). The PMS subjects did not display a significant increase in LH concentration in response to naloxone in the midluteal phase. There were no significant LH responses to naloxone in either group in the late luteal phase. There were no significant differences in estradiol, progesterone, or prolactin concentrations or estrogen to progesterone ratios between groups.
Control women have an enhanced central opioid tone during the midluteal phase that diminishes and becomes minimal in the late luteal phase of the menstrual cycle. In contrast, women with PMS have a loss of central opioid tone during the midluteal phase as indicated by the loss of LH response to naloxone. This attenuated central opioid tone in women with PMS as compared with asymptomatic control women may play a role in the pathophysiology of PMS.
评估经前瞻性记录确诊为经前综合征（PMS）的女性以及处于月经周期黄体中期和晚期的对照女性的中枢阿片类活性。
在治疗前1小时（08:00）和治疗后2小时（09:00 - 11:00）每隔15分钟采集一次血液。治疗以随机方式进行，包括1毫克或4毫克纳洛酮或安慰剂，并检测血液中的黄体生成素（LH）。在08:00和09:00测量基线雌二醇、孕酮和催乳素。
在对照的黄体中期，纳洛酮引起的LH曲线下面积和平均LH显著增加（P <.001）。PMS受试者在黄体中期对纳洛酮的反应中，LH浓度没有显著增加。在黄体晚期，两组对纳洛酮均无显著的LH反应。两组之间的雌二醇、孕酮或催乳素浓度或雌激素与孕酮比值没有显著差异。
对照女性在月经周期的黄体中期中枢阿片类张力增强，在黄体晚期减弱并降至最低。相比之下，PMS女性在黄体中期中枢阿片类张力丧失，这通过对纳洛酮的LH反应丧失得以体现。与无症状对照女性相比，PMS女性这种减弱的中枢阿片类张力可能在PMS的病理生理学中起作用。
