Materiały źródłowe

• #1 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  Premenstrual syndrome (PMS) encompasses clinically significant somatic and psychological manifestations during the luteal phase of the menstrual cycle, leading to substantial distress and impairment in functional capacity. These symptoms disappear within a few days of the onset of menstruation. The etiology of premenstrual syndrome is uncertain. Since PMS symptoms occur simultaneously with the hormonal fluctuations of the menstrual cycle, hormonal disproportion like estrogen surplus and progesterone deficiency have been proposed. Symptoms are also associated with serotonin to link as a key etiological factor. Estrogen levels that fluctuate during the luteal phase are what is responsible for women’s mood changes. Clinical trials have shown that serotonin precursors significantly increase between days 7 to 11 and 17 to 19 of the menstrual cycle. This indicates that PMS is closely associated with mood disorders through estrogen-serotonin regulation. According to the molecular biology studies, the decreased estrogen causes the hypothalamus to release norepinephrine, which triggers a decline in acetylcholine, dopamine, and serotonin that leads to insomnia, fatigue, depression, which are common symptoms of PMDD and PMS. A study from Egypt revealed the positive association between PMS and excess intake of sweet-tasting food items. It also showed that other factors, such as intake of junk food and coffee, were significantly associated with PMS. Thus, making it evident that lifestyle factors have a significant association with PMS and PMDD.

• #1 Premenstrual syndrome (PMS) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780

  Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition: […] Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause. […] Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that’s thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems. […] Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.

• #1 Premenstrual Syndrome (PMS): Causes, Symptoms, and Treatment

  https://www.healthline.com/health/premenstrual-syndrome

  PMS is the changes in mood, emotions, physical health, and behavior that can occur between ovulation and the start of your period. […] Contrary to what some people may suggest, PMS is a real condition, one that can disrupt daily life and cause significant physical discomfort and emotional distress. […] Scientific research hasn’t led to a conclusive cause of PMS, or an explanation for why some people experience it more severely than others. That said, researchers have suggested a few different theories. […] Many experts believe PMS happens in response to changing levels of the hormones estrogen and progesterone. […] These hormones naturally fluctuate throughout your menstrual cycle. During the luteal phase, which follows ovulation, hormones reach a peak and then decline rapidly, which may lead to anxiety, irritability, and other changes in mood.

• #1 Premenstrual Syndrome: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/953696-overview

  Premenstrual syndrome (PMS) is a cyclical, luteal-phase condition characterized by physical, psychological, and/or behavioral changes of sufficient severity to interfere with normal activity. […] The definitive cause of PMS is unknown and may be multifactorial. Some theories about the causes of PMS have fallen out of favor, including estrogen excess, estrogen withdrawal, pyridoxine (vitamin B6) deficiency, alteration of glucose metabolism, and fluid-electrolyte imbalances. Current research provides some evidence supporting the following etiologies: […] Hormonal shifts are a factor in PMS given the timing of the symptoms. However, patients with and without PMS have similar hormone levels. PMS therefore may represent an exaggerated response to normal hormonal changes, producing more pronounced emotional and physical responses.

• #1 PMS (premenstrual syndrome)

  https://www.nhs.uk/conditions/pre-menstrual-syndrome/

  It’s not fully understood why women get PMS (premenstrual syndrome). […] But it may be because of changes in their hormone levels during the menstrual cycle. […] Some women may be more affected by these changes than others.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Causes-of-Premenstrual-Syndrome-(PMS).aspx

  Premenstrual syndrome or PMS is physical, emotional and hormonal disturbances just before the beginning of a womans menstrual periods that subsides after the beginning of the period. […] The exact cause of PMS has not been identified. […] There are many theories that describe the causes of PMS. Some these include hormonal disturbances, chemical changes in the brain and so forth. […] It has been shown that women with PMS often respond differently to the fluctuations of the female hormones that occur during a menstrual cycle. […] Researchers speculate that excessive estrogen, progesterone deficiency, elevated prolactin, increased aldosterone could be associated with PMS symptoms. […] Certain chemicals in the brain may also play a role in PMS. These include chemical messengers of the brain called serotonin.

• #1 Premenstrual syndrome: new insights into etiology and review of treatment methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11075635/

  The dysregulation of the HPA axis may be caused by cyclical stressors experienced over time. […] The additional importance of hormones is underscored by estrogens ability to promote growth factors, such as BDNF. […] SSRIs, used in the treatment of PMS, also stimulate its formation, and their effectiveness in treatment serves as indirect evidence of the importance of disturbances in serotonergic conduction in the etiopathogenesis of this pathology. […] Genetic studies have not provided clear conclusions regarding the specific genes that are reliably involved in the development of PMS. However, family studies suggest a discernible genetic component and align with the theory of the existence of a subgroup of susceptible patients.

• #1 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  The pathophysiology of premenstrual syndrome is complex, imprecise, and is not fully understood. It is anticipated that PMS is likely to be influenced by the action of progesterone on neurotransmitters like gamma-aminobutyric acid (GABA), opioids, serotonin, and catecholamine. Preexisting serotonin deficiency with increased progesterone sensitivity is also considered responsible for this disorder. An increase in prolactin levels or an increase in its sensitivity to the effect of prolactin, glucose metabolism alterations, abnormal hypothalamic-pituitary-adrenal (HPA) axis function, insulin resistance, and certain nutritional electrolyte deficiencies, and genetic factors have a role in PMS.

• #1 Premenstrual syndrome: new insights into etiology and review of treatment methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11075635/

  Premenstrual syndrome (PMS) is a common disorder affecting women of reproductive age, with an estimated global prevalence of 47.8%, with severe symptoms occurring in 3-8%, significantly affecting daily functioning. GABA conductance and changes in neurosteroid levels, particularly allopregnanolone, are suspected to play a substantial role in the disorders etiology. […] The pathogenesis of PMS is intricate and not fully understood. Several theories attempt to explain the causes of its symptoms. Classically, PMS has been linked to hormonal fluctuations during the monthly cycle, with mood deterioration and increased anxiety primarily associated with decreases in estrogen and progesterone. […] Recently, particular attention has been given to the progesterone metabolite allopregnanolone. […] Understanding the significance of allopregnanolone in alleviating PMS symptoms may provide crucial information about the cause of the disorder itself.

• #1 Premenstrual syndrome: new insights into etiology and review of treatment methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11075635/

  The steroidal structure of progesterone and its metabolites enables them to penetrate the blood-brain barrier when formed peripherally, as observed in the ovaries. […] It is important to note that the presence of PMS is a risk factor for PPD. […] Both conditions are believed to be caused by hormonal changes, specifically the increase and subsequent withdrawal of sex hormones, and the existence of subgroups of susceptible individuals. […] Due to these associations and the increased interest in neurosteroids, allopregnanolone has become one of the most commonly linked substances to the etiology of PMS in recent years. […] Women experiencing premenstrual symptoms demonstrate an impaired stress response. […] This may be precisely linked to the action of steroid hormones, which, through various mechanisms, inhibit the activity of the HPA axis.

• #1 Premenstrual syndrome mechanism in the brain | 2021, Volume 7 – Issue 2 | Demiroglu Science University Florence Nightingale Journal of Medicine

  https://journalmeddbu.com/full-text/250

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] The factors leading to CNS malfunctions in PMS have not been entirely understood. […] Many symptoms of PMDD, on the other hand, are comparable to psychiatric conditions involving the serotonergic system, and the links between the serotonergic system and progesterone have focused researchers attention on serotonergic regulation.

• #1 Premenstrual syndrome Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/premenstrual-syndrome

  Premenstrual syndrome (PMS) can produce physical and emotional or behavioral symptoms in the days before menstruation. […] Doctors do not know exactly what causes PMS. Fluctuations in female reproductive hormones (progesterone or estrogen) and brain chemicals may play a role although their exact significance is unclear. […] Disruptions in the hypothalamic-pituitary-adrenal (HPA) system may be involved with PMS and premenstrual dysphoric disorder (PMDD). […] While hormonal and brain chemical changes certainly play a role, it is not exactly clear how they cause PMS or PMDD. Cyclic fluctuations in some of these hormones, and not whether their levels are high or low, may be the important factors in premenstrual problems.

• #1 Premenstrual syndrome mechanism in the brain | 2021, Volume 7 – Issue 2 | Demiroglu Science University Florence Nightingale Journal of Medicine

  https://www.journalmeddbu.com/full-text/250

  Premenstrual syndrome (PMS) is a disorder in which a set of physical, emotional, and behavioral symptoms, mostly seen in the late luteal phase of the menstrual cycle, disappear with the onset of menstruation. […] Although the exact cause of these disorders is unknown, numerous theories have been proposed, including gonadal hormones, neurotransmitters, central nervous system (CNS) abnormalities, diet, genetic factors, and environmental factors. […] Premenstrual syndrome is thought to be caused by a malfunction of the hypothalamic-pituitary-adrenal (HPA) axis, which causes problems with adrenal hormone secretion and nutritional inadequacies. […] Likewise, endocrine system assumption is used to explain the PMS physiopathological process. […] In the hormonal etiology of PMDD, physiological changes in gonadal hormones are thought to trigger central neurochemical reactions that reveal symptoms.

• #1 Premenstrual syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Premenstrual_syndrome

  Premenstrual syndrome (PMS) is a disruptive set of emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period. […] The cause of PMS is unknown, but the underlying mechanism is believed to involve changes in hormone levels during the course of the whole menstrual cycle. […] While PMS is linked to the luteal phase, the causes of PMS are not clear, but several factors may be involved. Changes in hormones during the menstrual cycle seem to be an important factor, with changing hormone levels affecting some more than others. […] PMS occurs more often in those who are in their late 20s and early 40s, have at least one child, have a family history of depression, and have a past medical history of either postpartum depression or a mood disorder.

• #1 Premenstrual Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0415/p1743.html

  Premenstrual syndrome, a common cyclic disorder of young and middle-aged women, is characterized by emotional and physical symptoms that consistently occur during the luteal phase of the menstrual cycle. […] Although the etiology of these disorders remains uncertain, research suggests that altered regulation of neurohormones and neurotransmitters is involved. […] The etiology of PMS remains unknown and may be complex and multifactorial. The role of ovarian hormones is unclear, but symptoms often improve when ovulation is suppressed. […] Some evidence suggests that the disorder is related to enhanced sensitivity to progesterone in women with underlying serotonin deficiency. […] Deficiencies in prostaglandins, related to an inability to convert linoleic acid to prostaglandin precursors, may be involved in PMS. […] Genetic factors also seem to play a role, as the concordance rate is two times higher in monozygotic twins than in dizygotic twins.

• #1 The Etiology of Premenstrual Dysphoric Disorder: 5 Interwoven Pieces – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/etiology-premenstrual-dysphoric-disorder/

  The many variables that contribute to the pathophysiology of PMDD overlap and should be considered connecting pieces in the puzzle that is the etiology of this disorder. In reviewing the literature, we have identified 5 topics likely to be major contributors to this disorder: genetic susceptibility, progesterone and allopregnanolone (ALLO), estrogen, serotonin, and brain-derived neurotrophic factor (BDNF), putative brain structural and functional differences, further involvement of the hypothalamic–pituitary–adrenal (HPA) axis and hypothalamic–pituitary–gonadal (HPG) axis: trauma, resiliency, and inflammation. […] PMDD is thought to have a heritability range between 30% to 80%. This is demonstrated by family and twin studies and specific genetic studies. The involvement of genetics means an underlying neurobiologic pathophysiology is in place.

• #1 Premenstrual syndrome mechanism in the brain | 2021, Volume 7 – Issue 2 | Demiroglu Science University Florence Nightingale Journal of Medicine

  https://www.journalmeddbu.com/full-text/250

  Studies show that women with PMS exhibit abnormal serotonergic function during the luteal phase. […] The regulatory role of the Val158Met genotype and the investigation of the less functional variant of Val66Met were mentioned in numerous gene studies, and it was suggested that 5-HTTLPR and MAOA-uVNTR polymorphisms be investigated. […] It has been proven that the vitamin D receptor (VDR) Fok1 polymorphism is significantly associated with PMS, the presence of Ff and ff genotypes increases the susceptibility to premenstrual disorders. […] The etiology of PMS is associated with cognitive and psychosocial learning theories. […] Functions of the CNS, abnormal responses to normal hormonal changes, changes in GM volume in the brain, differences in activities in the resting state of the brain, abnormalities in the limbic system, causes of disturbances in emotion processing and regulation, genetic predispositions and their explanations, and the role of nutrition, mineral, and vitamin intake were presented to shed light on the mechanism. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #1 Premenstrual Syndrome: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/953696-overview

  Serotonin deficiency is a potential contributor, as patients who are most affected by PMS may have decreased serotonin levels. Symptoms of PMS can respond to selective serotonin reuptake inhibitors (SSRIs), which increase the amount of available serotonin. […] Magnesium and calcium deficiencies are postulated as nutritional factors in PMS, and studies evaluating supplementation show improvement in physical and emotional symptoms. […] Other theories under investigation include increased endorphins, altered sensitivity of the gamma-aminobutyric acid (GABA) to allopregnanolone, genetics, and inflammation.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Causes-of-Premenstrual-Syndrome-(PMS).aspx

  Low serotonin also leads to fatigue, food cravings and difficulty in sleeping. […] A diet rich in salt, caffeine, alcohol or fat may also aggravate PMS symptoms. […] Low levels of certain vitamins (like vitamin B6) and minerals are thought to influence PMS as well. […] Women who are obese or who take little or no exercise are also at a higher risk of PMS. […] Other causes of PMS include: Social, cultural background also seems to play a role in risk of PMS. […] Women with a family history of the condition, or with a certain biological or psychological factors […] Those with severe PMS may also have a psychiatric disorder called premenstrual dysphoric disorder. […] Excessive emotional stress, anxiety etc. may lead to aggravated symptoms of PMS.

• #1 Premenstrual syndrome (PMS): Symptoms, Causes and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Numbe

  https://www.pacehospital.com/premenstrual-syndrome-pms-symptoms-causes-risk-factors-treatment-and-prevention

  Premenstrual Syndrome Causes […] The causes of premenstrual syndrome (PMS) are not fully understood because premenstrual symptoms co-occur with the hormonal changes of the menstrual cycle. The following are some of the causes of premenstrual syndrome which include: […] Hormonal changes: Hormonal changes like excess oestrogen, progesterone deficiency and fluctuation of oestrogen levels during the luteal phase are responsible for mood changes leading to premenstrual syndrome. […] Chemical changes in the brain: Serotonin is a neurotransmitter and an etiological factor that regulates mood. Symptoms of PMS are linked to serotonin levels. The substances the body uses to produce serotonin are known as Serotonin precursors, and they increase significantly between 7 to 11 days and 17 to 19 days of the menstrual cycle causing PMS. […] Hence, PMS is closely related to mood disorders through the regulation of oestrogen-serotonin levels. […] Progesterone interaction: It is believed that the interaction of progesterone with neurotransmitters is influenced by PMS. Preexisting serotonin deficiency combined with high levels of progesterone plays a role in the development of PMS. […] Prolactin levels: High prolactin levels are linked with low levels of oestrogen, which may cause symptoms such as depression. The association of High prolactin levels with low levels of progesterone may cause symptoms such as anxiety or irritability. […] Glucose metabolism alterations and insulin resistance: Lower blood glucose levels and insulin resistance were found after ovulation or during the luteal phases of the menstrual cycle. Hence, hypoglycaemia is a stimulating factor of PMS symptoms. […] Abnormal hypothalamic–pituitary–adrenal (HPA) axis function: The HPA axis controls various physiological processes and stress responses, including the production of hormones. HPA axis abnormalities are a factor linked to premenstrual syndrome (PMS), particularly the hormonal fluctuations that occur during the menstrual cycle.

• #1

  https://journals.lww.com/jfmpc/fulltext/2018/07020/biopsychosocial_etiology_of_premenstrual_syndrome_.13.aspx

  In a hypothesis, it is stated that the immune system is suppressed in the luteal phase, and as the immune system becomes weak, pathogens increase their activities, which in turn leads to development of PMS symptoms. […] The symptoms include cases of irritability, aggression, tension, anxiety, depression, lethargy, insomnia, poor coordination in concentration, and mental disorders such as the feeling of being reluctant toward oneself and being suppressed. […] The hypothesis of increased enthusiasm and jealousy in men states that PMS is the woman’s hostility toward her male partner late in the luteal phase, which is the result of losing opportunities for mating. […] The results were collected from different and contradictory hypotheses on PMS and social and religious attitudes toward PMS.

• #1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders

  https://www.mdpi.com/2673-396X/3/1/12

  The most characteristic aspect of PMS/PMDD is the temporal relation between the appearance of symptoms and the menstrual phase, indicating a role for gonadal steroid hormones and their metabolites in influencing the plethora of biological systems that contribute to the adjustments required to fulfil reproductive goals. […] However, women with PMS/PMDD do not show abnormalities in the reproductive hormone release pattern; rather, they seem to display a more sensitive neuroendocrine threshold to cyclical variations of estrogens and progesterone, which may give origin to catamenial symptoms and exacerbation of mood disorders during reproductive transitions. […] The co-occurrence with pathological manifestations displaying premenstrual exacerbations supports a common neuroendocrine etiology. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

• #1 Premenstrual Dysphoric Disorder: Causes and Risk Factors

  https://www.verywellhealth.com/pmdd-causes-4122124

  Women with PMDD may experience an exaggerated drop in serotonin levels. […] Low serotonin levels are associated with the depressed mood, food cravings, and impaired cognitive functioning of PMDD. […] There is a genetic basis for the hormonal sensitivities that appear to be at work in PMDD. […] Researchers at the National Institute of Health found that women with PMDD have changes in one of the gene complexes that control how they respond to estrogen and progesterone. […] Early research in this area suggests that women with more significant premenstrual symptoms may have an increased inflammatory response during the luteal phase compared to women with minimal symptoms. […] Researchers are looking at the relationship between ALLO and the stress response in women with PMDD. […] The correlation between stress and worsening PMDD symptoms is currently an area of active investigation. […] Research shows that 50% of women diagnosed with PMDD also have an anxiety disorder, compared with 22% of women without PMDD. […] Having a family history of mood disorders increases the likelihood of PMDD as well. […] Cigarette smoking is linked to an increased risk of severe PMS and PMDD.

• #1 Premenstrual Dysphoric Disorder: Practice Essentials, Background, Pathophysiology and Etiology

  https://emedicine.medscape.com/article/293257-overview

  The psychosocial theory hypothesizes that PMDD or PMS is a conscious manifestation of a person’s unconscious conflict about femininity and motherhood. […] The cognitive and social learning theory hypothesizes that the onset of menses is an aversive psychological event for those susceptible to PMDD. […] Finally, the sociocultural theory hypothesizes that PMDD is a manifestation of the conflict between the dual roles society expects individuals to fill simultaneouslynamely, productive workers and child-rearing parents. […] Of these five theories, the serotonin theory is perhaps the most popular at present. […] Risk factors for PMDD include the following: Personal history of a major mood disorder, a family history of mood disorder, premenstrual depression, premenstrual mood changes, history of sexual abuse, past, present, or current domestic violence.

• #1

  https://journals.lww.com/jfmpc/fulltext/2018/07020/biopsychosocial_etiology_of_premenstrual_syndrome_.13.aspx

  Culture affects the probability of development and prevalence of PMS. […] A woman’s religion can extremely affect her menstrual distress. […] Feminist activists have questioned the philosophy of menstruation and the current state of shame from menstruation, secrecy and silence, and attempted to directly and indirectly hold workshops through visual and artistic performances, celebrations, and sarcasm to provide information and produce and distribute small and big journals using websites, blogs, and other social media. […] The results of a study that focused on the role of health education in menstruation showed that it can be effective in mental health among girls due to the delicate nature of giving information about menstruation onset and its expectations.

• #1 What causes my PMS?

  https://www.missinformed.ca/post/what-causes-my-pms

  PMS can be confusing because it encompasses such a diverse range of physical, emotional and behavioural symptoms that are unique to individuals, with no definitive lab tests to diagnose. […] Research is inconclusive about the fundamental cause of PMS as it can often be multifactorial. At its core, it is believed that PMS is due to the hormonal changes menstruators experience during the mid- to late-luteal phase. Importantly, it is an individuals sensitivity to the fluctuations and the biological effects of progesterone and estrogen that trigger PMS symptoms. […] Due to the multifactorial nature of PMS, there are a wide variety of treatment options. […] In the last decade, research has suggested that PMS is a Western disorder and is partly dependent on how menstruation is described and discussed in a culture.

• #1 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Many women feel physical or mood changes during the days before menstruation. When these symptoms happen month after month, and they affect a woman’s normal life, they are known as premenstrual syndrome (PMS). […] Symptoms of other conditions can mimic PMS or overlap with PMS. Some of these conditions include depression, anxiety, perimenopause, chronic fatigue syndrome, irritable bowel syndrome (IBS), and thyroid disease. […] Depression and anxiety disorders are the most common conditions that overlap with PMS. About half of women seeking treatment for PMS have one of these disorders. […] In addition to depression and anxiety, symptoms of other disorders can get worse right before your period. Examples include seizure disorders, migraines, asthma, and allergies. […] If PMS symptoms are severe and cause problems with work or personal relationships, you may have premenstrual dysphoric disorder (PMDD). PMDD is a severe type of PMS that affects a small percentage of women.

• #1 Premenstrual syndrome, a common but underrated entity: review of the clinical literature – Journal of the Turkish-German Gynecological Association

  https://www.jtgga.org/articles/premenstrual-syndrome-a-common-but-underrated-entity-review-of-the-clinical-literature/doi/jtgga.galenos.2021.2020.0133

  Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are characterized by somatic and psychologic symptoms that arise at the luteal phase of the menstrual cycle and subside with menstruation. […] Sex steroids and neurotransmitters have a central role in the etiology. […] Although various hypotheses have been put forward, the etiology of PMS and PMDD is not fully understood. […] The best-known hypothesis is the presumed role of circulating gonadal steroids in the development of PMS symptoms, as suppression of ovulation has a beneficial effect on PMS. […] Current evidence suggests that PMS is a disorder triggered by changes in gonadal steroids during the LPMC in susceptible women. […] Current studies highlight the pivotal role of serotonin in the etiology of PMS. […] The role of minerals and vitamins in the etiology of PMS is still controversial.

• #2 Premenstrual syndrome (PMS) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780

  Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition: […] Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause. […] Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that’s thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems. […] Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.

• #2 Premenstrual Syndrome (PMS): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24288-pms-premenstrual-syndrome

  Premenstrual syndrome (or PMS) begins one to two weeks before you get your period. It can cause symptoms like headaches, breast soreness and mood swings. […] The exact cause is unknown. But most healthcare providers believe PMS happens due to hormonal changes related to your menstrual cycle. […] Symptoms usually show up around ovulation, when levels of estrogen and progesterone increase. Once your period begins, these hormone levels drop for a few days, and then, will start to rise again. These hormonal changes may be to blame for PMS. Some people are more sensitive to hormonal fluctuations, which may explain why PMS affects everyone differently.

• #2 Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics/print

  Premenstrual syndrome (PMS) refers to a group of physical and behavioral symptoms that occur in a cyclic pattern during the second half of the menstrual cycle. […] The cause of PMS and PMDD is not known. Some women may be very sensitive to changes in hormone levels. Hormone levels are normal and fluctuate before and during the menstrual period. […] However, it is not clear why some women develop premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) and others do not. Levels of estrogen and progesterone are similar in women with and without these conditions. The most likely explanation, based upon several studies, is that women who develop PMDD are highly sensitive to normal changes in hormone levels.

• #2 Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics

  Premenstrual syndrome (PMS) refers to a group of physical and behavioral symptoms that occur in a cyclic pattern during the second half of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is the severe form of PMS. Common symptoms include anger, irritability, depression, and internal tension that are severe enough to interfere with daily activities. […] The cause of PMS and PMDD is not known. Some women may be very sensitive to changes in hormone levels. Hormone levels are normal and fluctuate before and during the menstrual period. […] Studies suggest that rising and falling levels of hormones (eg, estrogen and progesterone) may also influence chemicals in the brain, including a substance called serotonin, which affects mood. […] However, it is not clear why some women develop premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) and others do not. Levels of estrogen and progesterone are similar in women with and without these conditions. The most likely explanation, based upon several studies, is that women who develop PMDD are highly sensitive to normal changes in hormone levels.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Causes-of-Premenstrual-Syndrome-(PMS).aspx

  Low serotonin also leads to fatigue, food cravings and difficulty in sleeping. […] A diet rich in salt, caffeine, alcohol or fat may also aggravate PMS symptoms. […] Low levels of certain vitamins (like vitamin B6) and minerals are thought to influence PMS as well. […] Women who are obese or who take little or no exercise are also at a higher risk of PMS. […] Other causes of PMS include: Social, cultural background also seems to play a role in risk of PMS. […] Women with a family history of the condition, or with a certain biological or psychological factors […] Those with severe PMS may also have a psychiatric disorder called premenstrual dysphoric disorder. […] Excessive emotional stress, anxiety etc. may lead to aggravated symptoms of PMS.

• #2 Premenstrual syndrome: new insights into etiology and review of treatment methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11075635/

  The steroidal structure of progesterone and its metabolites enables them to penetrate the blood-brain barrier when formed peripherally, as observed in the ovaries. […] It is important to note that the presence of PMS is a risk factor for PPD. […] Both conditions are believed to be caused by hormonal changes, specifically the increase and subsequent withdrawal of sex hormones, and the existence of subgroups of susceptible individuals. […] Due to these associations and the increased interest in neurosteroids, allopregnanolone has become one of the most commonly linked substances to the etiology of PMS in recent years. […] Women experiencing premenstrual symptoms demonstrate an impaired stress response. […] This may be precisely linked to the action of steroid hormones, which, through various mechanisms, inhibit the activity of the HPA axis.

• #2 Premenstrual syndrome (PMS)

  https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome

  Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. […] Researchers think that PMS happens in the days after ovulation because estrogen and progesterone levels begin falling dramatically if you are not pregnant. […] PMS symptoms may happen more often in women who have high levels of stress, have a family history of depression, or have a personal history of either postpartum depression or depression. […] PMS symptoms may get worse as you reach your late 30s or 40s and approach menopause and are in the transition to menopause, called perimenopause. […] Researchers do not know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role.

• #2 Premenstrual Syndrome (PMS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/premenstrual-syndrome-pms

  Premenstrual syndrome (PMS) is a recurrent luteal-phase disorder characterized by irritability, anxiety, emotional lability, depression, edema, breast pain, and headaches, occurring during the 5 days before and usually ending a few hours after onset of menses. […] The cause of PMS is unclear. […] Possible causes or contributing factors include multiple endocrine factors (eg, hypoglycemia, other changes in carbohydrate metabolism, hyperprolactinemia, fluctuations in levels of circulating estrogen and progesterone, abnormal responses to estrogen and progesterone, excess aldosterone or antidiuretic hormone [ADH]), genetic predisposition, serotonin deficiency, and possibly magnesium and calcium deficiencies. […] Serotonin deficiency is thought to contribute because women who are most affected by PMS have lower serotonin levels and because selective serotonin reuptake inhibitors (SSRIs), which increase serotonin, sometimes relieve symptoms of PMS. […] Magnesium and calcium deficiencies may contribute.

• #2 Premenstrual Syndrome (PMS) Symptoms, Treatments & Defintion

  https://www.emedicinehealth.com/premenstrual_syndrome_pms/article_em.htm

  Premenstrual syndrome involves a variety of physical, mental, and behavioral symptoms tied to a woman’s menstrual cycle. […] By definition, PMS symptoms and signs occur during the 2 weeks before a woman’s period starts, known as the luteal phase of the menstrual cycle. […] PMS is a complex health concern. A significant portion of menstruating women are believed to suffer from PMS. […] PMS usually occurs in women in their fourth and fifth decades of life (aged 30-49 years). […] Because many different processes may contribute to PMS, methods of treatment vary widely and can include medical and alternative approaches. […] PMS and PMDD are thought to result from an interaction between the changing sex hormone levels during the luteal phase of the menstrual cycle and neurotransmitters in the brain, particularly the neurotransmitter serotonin, in susceptible women.

• #2

  https://journals.lww.com/jfmpc/fulltext/2018/07020/biopsychosocial_etiology_of_premenstrual_syndrome_.13.aspx

  Premenstrual syndrome (PMS) is one of the most prevalent disorders at reproductive age and has a negative impact on emotions and performance of women. […] Since various factors play a role in the development of this syndrome, the present study was aimed to examine biopsychosocial etiology of PMS in the form of a narrative review. […] The cause of PMS has remained unknown, and the research results refer to multiplicity of its causes. […] Genetic factors, familial inheritance, the role of and changes in sex hormones, neurotransmitters and central nervous system, environmental factors, depression, migraine, and lack of social and emotional support can affect the development and intensity of the symptoms. […] According to what was said above, it is highly necessary to examine biological, psychological, and social etiologies of PMS, and discussion of more intellectual and diverse approaches is needed.

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