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PMS/PMDD Treatment using Lupron Depot with Add-Back Hormones
I am a 41 year old woman who has been experiencing PMDD (or what I refer to as PMS in the extreme as PMDD is not an official diagnosis) for roughly five years now. The psychological and physiological symptoms are very clear to me due to their relation to my menstrual cycle (two weeks prior to period/luteal phase). I am not as regular as I was when I was in my twenties and also experience the occasional ovarian cysts.  

My GP put me on Ocella. No improvement. Then Effexor XR was added. Little improvement.

I went to a reproductive endocrinologist yesterday. He is a clinician and researcher who speaks on PMS often. After an hour and a half with me (sweet relief!) he determined the best thing to do was to put me in medically-induced menopause using a Lupron Depot shot every month for a three-month trial. He had me toss out my birth control pills.

He also used an "add-back" of the Virelle Dot 0.1mg estrogen patch and a 2.5 mg progesterone pill. I will, again, be doing this for three months so he can determine the best course of long-term action for me after we test the PMS symptoms in three months to see if this brought me any relief.

I have read in medical literature that Lupron Depot alone provides GREAT relief for extreme PMS. I have also read research literature that estrogen and progesterone add-back therapy negate the effects of the Lupron shot, and the PMS comes back.

Question 1: Does Lupron Depot stop estrogen, progesterone and testosterone (any any other hormones) from circulating through the body when someone takes this?

Question 2: Does anyone know of a reason why estrogen and progesterone add-backs are necessary with the Lupron Depot shot if it works so well on it's own? I understood from the doctor that it's important for a woman to keep a certain level of estrogen and progesterone in the body.

Any comments from anyone about their being treated with Lupron Depot and/or Lupron Depot with add-backs, I'd love to hear your experiences since I'm on the front-end of this trial.

Thanks in advance.

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Avatar universal
I have PMDD and I've been treated with Lupron Depot and add back hormones for 10 years.  
Like a lot of people, my primary care physician and gyns prescribed sedatives and eventually prozac when that became popular.  My boss at work told me to stay home those days, and my Dr. agreed.  My fiancĂ© told me to see a shrink.  The shrink told me I was cyclical and about PMDD.  
One day my neighbor stopped me while I was walking the dog (he is a retired OBGYN).  He told me He noticed...and I didn't have to live that way.  He referred me to a Reproductive Endocrinologist.  He told me about this unusual off label treatment.  A few months later with the encouragement of everyone I knew I went on it.
The first six months were chaos and horrible.
The long term results are worth it.  I still have cycles, not menses, but hormonal stages before my shot.  I moved to the three month shot to reduce the occurrence.  Those cycles are about a 80-90% improvement.
I cannot express how life changing, life saving this has been for me.  
Yes, there are negatives to any treatment, but in my case the benefits outweigh any negatives.
I don't think I could have managed without it.  I wasn't managing too well before, and it was getting worse with age.
Come to find out I had a low progesterone problem which was never discovered before because I always took my test when I felt well...I could not go out when I was in PMDD time.  I couldn't carry to term.  
I never want to go back to life without treatment.
My feedback hormone daily treatment is prempro, by the way.  My bone density tests (DEXA) scans are normal.

To answer your questions, I think Lupron significantly lowers the production of hormones, and the add back gives you what you need.  I think we are fixing a hormonal imbalance this way.
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