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CLEAR – Eisenlohr-Moul Lab

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Ovarian Hormone Withdrawal and Suicide Risk: An Experimental Approach

K99R00MH109667

Menstrual cycle-linked hormone withdrawal is correlated with suicide attempts; in a series of two intensive mechanistic clinical trials, this K99/R00 award provides the first experimental evidence regarding the effects of menstrual cycle-linked ovarian hormone withdrawal on perimenstrual (around menses) increases in females with recent suicidality. These studies utilize transdermal estradiol (estrogen) patches and oral micronized progesterone pills to test several different hypotheses about the role of ovarian hormone withdrawal in worsening symptoms of suicidality among at-risk females. These intensive studies are the first of their kind. Results of the first experiment, completed at UNC Chapel Hill in 2017, strongly support the notion that perimenstrual worsening of suicidality is caused by natural perimenstrual withdrawal from ovarian hormones, and that prevention of that withdrawal using exogenous hormones can prevent these recurrent spikes in suicide risk that occur around menses onset. The R00 experiment will determine whether this effect is due to withdrawal from estrogen, progesterone, or both.

Using a Perimenstrual Steroid Stabilization Experiment to Validate a Smartphone-Based Assessment Protocol for Perimenstrual Mood Dysregulation and Suicidality

Gia Allemand Foundation

The purpose of this study is to pilot a smartphone-administered version of the Carolina Premenstrual Assessment Scoring System (C-PASS) diagnostic system for cyclical mood disorders in the context of the PI’s K99 award from NIMH. This project seeks to validate the steroid-sensitive nature of the C-PASS in the context of the K99 experimental design.