Gonadotropin-associated psychosis in perimenstrual behavior disorder

• Published in: Hormone research Vol. 40; no. 4; p. 141
• Main Authors: Constant, M, Abrams, C A, Chasalow, F I
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.1993
• Subjects: Child; Estradiol - blood; Female; Follicle Stimulating Hormone - blood; Humans; Leuprolide - therapeutic use; Luteinizing Hormone - secretion; Medroxyprogesterone Acetate - therapeutic use; Menarche; Menstruation - physiology; Psychotic Disorders - blood; Psychotic Disorders - drug therapy; Sexual Behavior - psychology
• ISSN: 0301-0163
• DOI: 10.1159/000183783

Sexually provocative and violent behavior have been reported as a result of excess androgens. We now report a temporal relationship between increased gonadotropin levels and behavioral changes in two adolescent girls who presented with a history of aggressive and bizarre sexual behavior coincident with the onset of menarche. We evaluated the possibility of a cyclical hormonal cause with daily measurements of gonadotropins, androgens and estradiol levels and correlated the results with periodic reports on the girls' behavior. We concluded that a correlation exists between periods of extremely violent and sexually provocative behavior and peaks of gonadotropin hormone secretion, even though androgen levels were normal. Treatment with medroxyprogesterone acetate (Depo-Provera) in one case and with leuprolide acetate (Lupron-Depot) in the other suppressed gonadotropin levels, and behavior improved markedly. Thus, the behavioral changes (or psychosis) seen in these girls might have been induced by increased levels of gonadotropins.