estradiol + progesterone (University of North Carolina at Chapel Hill)

estradiol + progesterone is a combination hormone therapy investigated by the University of North Carolina, Chapel Hill, for the prevention of perimenstrual suicidal ideation. The treatment involves the administration of transdermal estradiol and oral micronized progesterone to stabilize ovarian steroid levels during the late luteal phase, thereby buffering the rapid withdrawal of estradiol and progesterone-derived neurosteroids (such as allopregnanolone) that occurs naturally before menstruation. This withdrawal is hypothesized to trigger suicidal symptoms in vulnerable women. In a crossover randomized controlled trial (NCT03720847), this stabilization approach significantly reduced perimenstrual exacerbations of suicidal ideation, planning, depression, and hopelessness compared to placebo. The intervention uses bioidentical hormone preparations to maintain physiological stability rather than suppressing the cycle entirely.

Other names

oral micronized progesteronetransdermal estradiolestradiol and progesterone stabilization therapyperimenstrual steroid stabilization