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. […] 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. […] 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.

• #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, 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. […] The role of vitamins and minerals in the etiology and treatment of PMS and PMDD is open to discussion. […] 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. […] However, cyclic changes in ovarian steroids do not appear to be the only cause of PMS symptoms, as daily serum progesterone and estrogen concentrations are shown to be similar in women with and without PMS.

• #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

  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. […] In the hormonal etiology of PMDD, physiological changes in gonadal hormones are thought to trigger central neurochemical reactions that reveal symptoms.

• #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. […] 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. […] 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. […] Studies show that women with PMS exhibit abnormal serotonergic function during the luteal phase.

• #1 Premenstrual dysphoria disorder: It’s biology, not a behavior choice – Harvard Health

  https://www.health.harvard.edu/blog/premenstrual-dysphoria-disorder-its-biology-not-a-behavior-choice-2017053011768

  Broadly speaking, if you have PMDD, you have an increased sensitivity to your reproductive hormones during the two weeks before your period starts. This sensitivity leads to alterations in the brain chemicals and neurologic pathways that control your mood and your general sense of well-being. Exactly what that sensitivity is and what causes it has not been well understood. And treatment options have been limited. […] Researchers at the National Institutes of Health (NIH) have found that women with PMDD have an altered gene complex that processes the body’s response to hormones and stressors. This is a very important discovery, as it establishes a biological basis for the mood disturbances of PMDD. Not only is this validation for women who live with PMDD, but it also has tremendous implications for new and improved treatment options. […] Dr. Peter Schmidt, one of the lead researchers on the NIH study, published data that support the working theory that it is the changes in hormone levels, not just the hormones themselves, that trigger the symptoms of PMDD.

• #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 two best-studied neurotransmitter systems involved in the formation of symptoms are the GABAergic and serotonergic systems. […] Progesterone and serotonin coexist in cells in the brain’s median raphe nucleus, and progesterone promotes serotonin reuptake. […] Although there is compelling evidence that progesterone plays a role in the pathophysiology of PMS, studies have shown that the classical progesterone receptor is not involved in this process, and many double-blind randomized controlled trials (RCTs) have failed to demonstrate the efficacy of progesterone supplementation. […] The changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies.

• #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 PMS & PMDD – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

  Fluctuations in circulating estrogen and progesterone cause marked effects on central neurotransmission, specifically serotonergic, noradrenergic and dopaminergic pathways. Accumulating evidence particularly implicates the serotonergic system in the pathogenesis of PMS and PMDD. Recent data suggest that women with premenstrual mood disorders have abnormal serotonin neurotransmission, along with a lower density of serotonin transporter receptors, which is thought to be associated with symptoms such as irritability, depressed mood and carbohydrate craving. […] There may also be some role for gamma amino-butyric acid (GABA), the main inhibitory neurotransmitter, in the pathogenesis of PMS/PMDD. Allopregnanolone is a metabolite of progesterone and a positive modulator of the GABA receptor, enhancing the effects of GABA. […] Further supporting the role of GABA in the etiology of PMDD is the finding that women with PMDD may have a deficiency of GABAergic inhibition in their cerebellum.

• #1 Premenstrual Syndrome | AAFP

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

  Genetic factors also seem to play a role, as the concordance rate is two times higher in monozygotic twins than in dizygotic twins. […] Because serotonin has been implicated in the pathogenesis of PMS and PMDD, various SSRIs have been tested in these disorders. […] The ACOG recommends SSRIs as initial drug therapy in women with severe PMS and PMDD. […] Danazol is an androgenic agent that inhibits gonadotropin release, thereby improving mastalgia. […] GnRH agonists are synthetic analogs of naturally occurring GnRH and suppress ovulation by inhibiting the release of pituitary gonadotropins. […] Limited evidence suggests that estrogen therapy is efficacious in alleviating PMS symptoms. […] The administration of estrogen late in the luteal phase (to minimize premenstrual decline in the hormone) relieves premenstrual migraine. […] Although oral contraceptive pills (OCPs) are widely prescribed for the management of PMS, they have not been shown to be consistently effective.

• #1 Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder – PubMed

  https://pubmed.ncbi.nlm.nih.gov/22611222/

  Premenstrual syndrome (PMS) and premenstrual dysphoric disorder are triggered by hormonal events ensuing after ovulation. […] Although evidence for a hormonal abnormality has not been established, the symptoms of the premenstrual disorders are related to the production of progesterone by the ovary. […] The two best-studied and relevant neurotransmitter systems implicated in the genesis of the symptoms are the GABArgic and the serotonergic systems. […] Metabolites of progesterone formed by the corpus luteum of the ovary and in the brain bind to a neurosteroid-binding site on the membrane of the gamma-aminobutyric acid (GABA) receptor, changing its configuration, rendering it resistant to further activation and finally decreasing central GABA-mediated inhibition. […] The lowering of serotonin can give rise to PMS-like symptoms and serotonergic functioning seems to be deficient by some methods of estimating serotonergic activity in the brain; agents that augment serotonin are efficacious and are as effective even if administered only in the luteal phase.

• #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

  The two best-studied neurotransmitter systems involved in the formation of symptoms are the GABAergic and serotonergic systems. […] Allopregnanolone is one of the few endogenous progesterone metabolites that has a substantial positive modulatory impact on the GABAA receptor in the brain and is involved in mood disorders in both men and women. […] The changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] The HIPP and hypothalamus are the most studied anatomical regions in understanding the pathogenesis of PMS. […] Abnormalities in these regions also play a role in other mood disorders. […] Allopregnanolone is produced in the next step of 5-reductase type I and 3-HSD enzymes from progesterone, and these two enzymes are mostly found in the cerebral cortex, HIPP, and amygdala regions of the brain. […] A study evaluating the neural activity pattern in PMS patients at rest in the luteal phase found decreased fALFF in the ACC and increased fALFF in the precuneus, left inferior temporal cortex, and HIPP.

• #1 Pathophysiology – Primary Care Notebook

  https://gpnotebook.com/en-US/pages/gynaecology/premenstrual-syndrome/pathophysiology

  The pathophysiology of premenstrual syndrome (PMS) is centred around the ovarian hormone cycle. This theory is based on the fact that patients do not exhibit symptoms before puberty, during pregnancy, after menopause, and during treatment with gonadotrophin-releasing hormone (GnRH) analogues. […] rst theory suggests that some women are sensitive to progesterone and progestogens, since the serum concentrations of oestrogen or progesterone are the same in those with or without PMS […] second theory implicates the neurotransmitters serotonin and -aminobutyric acid (GABA) […] serotonin receptors are responsive to oestrogen and progesterone, and selective serotonin reuptake inhibitors (SSRIs) are proven to reduce PMS symptoms. […] GABAA receptors are associated with alterations in mood, cognition, and affect. GABA levels are modulated by the metabolite of progesterone, allopregnanolone, and in women with PMS the allopregnanolone levels appear to be reduced.

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

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

  Disruptions in the hypothalamic-pituitary-adrenal (HPA) system may be involved with PMS and premenstrual dysphoric disorder (PMDD). The HPA system controls reproduction, appetite, and feelings of well-being, and is also involved in regulating the stress response. A number of hormones and neurotransmitters (chemical messengers in the brain) play important and complicated interrelated roles in the activity of the HPA system: Reproductive hormones. The two important female hormones, progesterone and estrogen, are at their highest levels during the premenstrual period. PMS may be more strongly related to an abnormal response to progesterone than estrogen. […] 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 The Etiology of Premenstrual Dysphoric Disorder: 5 Interwoven Pieces – MGH Center for Women’s Mental Health

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

  Imaging studies have suggested differences in brain structure in women with PMDD, with a focus on the amygdala and the prefrontal cortex. […] Altered cortisol levels (higher during the luteal phase and lower during times of stress) suggest a possibly altered HPA axis in some women with PMDD. […] The possible role of inflammation in PMDD deserves further investigation. The luteal phase entails an increase in the production of proinflammatory markers. […] Because PMDD is heritable, it must have an underlying neurobiologic pathophysiology. Brain imaging studies show differences in structure and function in women with PMDD across the menstrual cycle. […] Currently, the main leading theory is that PMDD is a result of “an abnormal response to normal hormonal changes.” […] The etiology of PMDD is complex. PMDD may be a disorder of withdrawal caused by a transient decline in neurosteroids.

• #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. […] 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. […] Chronic exposure to progesterone and ALLO (a main progesterone metabolite) and rapid withdrawal from ovarian hormones may play a role in the etiology of PMDD. […] Estrogen affects multiple neurotransmitter systems that regulate mood, cognition, sleep, and eating. Studying estrogen in context of PMDD is important because women with PMDD can have low mood, specific food cravings, and impaired cognitive function.

• #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 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.

• #1 Premenstrual syndrome, coping mechanisms and associated factors among Wolkite university female regular students, Ethiopia, 2021 | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01658-5

  Premenstrual syndrome (PMS) is defined as a collection of recurrent physical, cognitive, affective, and behavioral symptoms affecting women, occurring cyclically during the luteal phase of the menstrual cycle and resolving at or within a few days of the onset of menstruation. […] The definite etiology of PMS is not well understood and may be complex and multifactorial. Change in level of ovarian steroid hormones, decrease in endogenous opioid activity during the late luteal phase of the cycle and genetics may play a role in the occurrence of PMS. […] This study revealed that, students having family history of PMS were 4.05 times more likely to develop premenstrual syndrome as compared to those without family history. […] This implies that having family history of PMS had a positive impact on the presence of PMS.

• #1 Premenstrual Syndrome (PMS) – Women’s Health Issues – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/premenstrual-syndrome-pms

  PMS may occur partly because of the following: […] Estrogen and progesterone levels fluctuate during the menstrual cycle. Some women are more sensitive to these fluctuations. […] Serotonin levels tend to be lower in women with PMS. Serotonin is a substance that helps nerve cells communicate (a neurotransmitter) and is thought to help regulate mood. […] The fluctuations in estrogen and progesterone may affect other hormones, such as aldosterone, which helps regulate salt and water balance. Excess aldosterone can cause fluid retention and bloating. […] The diagnosis of PMS is based on symptoms. To identify PMS, doctors ask a woman to keep a daily record of her symptoms. […] If the symptoms disappear soon after the menstrual period begins, they are probably caused by PMS or premenstrual dysphoric disorder. […] GnRH agonists cause the ovaries to produce less estrogen and progesterone. Thus, they help control the rapid fluctuations in hormone levels that occur before menstrual periods and that contribute to symptoms.

• #1 Premenstrual syndrome: etiology, diagnosis and treatment. A mini literature review

  https://www.termedia.pl/Premenstrual-syndrome-etiology-diagnosis-and-treatment-A-mini-literature-review,113,33620,1,1.html

  The cyclic effect of estrogen and progesterone on serotonin, -aminobutyric acid, and dopamine systems may be the cause of changes in mood. […] These mechanisms can alter the renin-angiotensin-aldosterone (RAS) system, which could possibly explain some symptoms such as bloating, cramps, swelling and weight gain that occur during PMS. […] However, why some women develop PMS and others do not is unclear, as studies have shown that women diagnosed with PMS do not have a higher level of estrogen and progesterone than other women. […] The most likely explanation for this, based on several studies, is that women who develop PMS are more sensitive to normal changes in hormone levels during the menstrual cycle. […] Although no genes have been identified indicating hereditary nature of PMS, some studies suggest there could be a possible genetic component to premenstrual disorders.

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

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

  Even neuro-inflammation expressed via the GABAergic system is under investigation as an etiological factor of PMS/PMDD. […] 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 central nervous system (CNS) is one of the main target tissues for reproductive hormones but it is also a source of neurosteroids, which are involved throughout genomic and non-genomic mechanisms in a vast array of CNS functions far beyond the scope of the present overview. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

• #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

  Current evidence suggests that PMS is a disorder triggered by changes in gonadal steroids during the LPMC in susceptible women. […] This is thought to be due to the interaction between cyclic changes in ovarian steroids and the functioning of central neurotransmitters. […] One of the most frequently investigated neurotransmitters in PMS pathogenesis is serotonin, but beta-endorphine, gamma-aminobutyric acid (GABA) and the autonomic nervous system are also part of the pathogenesis of PMS. […] 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.

• #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. […] Many experts believe PMS happens in response to changing levels of the hormones estrogen and progesterone. […] 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. […] The neurotransmitters serotonin and norepinephrine have several important functions in the body, including helping regulate mood, emotions, and behavior. […] These chemical messengers may also factor into symptoms of PMS.

• #1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | Article | GLOWM

  https://www.glowm.com/article/heading/vol-4–benign-gynecology–premenstrual-syndrome-and-premenstrual-dysphoric-disorder/id/418533

  Allopregnanolone has neuroprotective effects and is important for development of the fetal brain. […] There are some indications that women with PMDD are unable to develop a physiological tolerance to allopregnanolone during the luteal phase of the menstrual cycle. […] The GABAA receptor is a membrane-bound chloride channel consisting of five subunits with a large number of combinations. The subunit composition of the GABAA receptor determines its pharmacodynamic properties, including sensitivity to neurosteroids. […] There are some indications that the plasticity of the GABAA receptor is involved in the pathophysiology of PMDD, but this research field is still in its infancy.

• #1 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | Article | GLOWM

  https://www.glowm.com/article/heading/vol-4–benign-gynecology–premenstrual-syndrome-and-premenstrual-dysphoric-disorder/id/418533

  The occurrence of PMDD and PMS symptoms is closely related to the luteal phase of the menstrual cycle, and requires ovulation and subsequent formation of a corpus luteum. […] Thus, hormones produced by the corpus luteum, such as progesterone and some of its metabolites, are suspected to provoke the symptoms. However, the hormonal cycle is not different in women with PMDD compared to those without premenstrual mood symptoms, and relationships with hormone deficiency or excess synthesis have not been found. […] The prevailing hypothesis today is that allopregnanolone, an endogenous metabolite of progesterone, is the provoking factor. This is evidenced by the finding that treatment with a 5-reductase inhibitor (blocking the key enzyme for synthesis of allopregnanolone) ameliorates PMDD symptoms.

• #1 Emotion Dysregulation of Women with Premenstrual Syndrome | Scientific Reports

  https://www.nature.com/articles/srep38501

  The aetiology and pathophysiology of PMS remain unclear. […] Some early studies attributed the cause of PMS to abnormal and excessive secretions of the reproductive hormones. […] However, recent studies failed to find any significant difference between women with and without PMS in the concentrations of reproductive hormones, which means PMS does not seem to be due to abnormal concentrations of sex steroids. […] Some researchers emphasize cognitive factors in the development of PMS. […] It is proposed that women with PMS may be interpreting physiological changes during the premenstrual phase in a negative way, and regarding them as threatening or depriving so that they feel anxious and depressed. […] This hypothesis was supported by the efficacy of cognitive therapy in treating PMS and PMDD.

• #1 Emotion Dysregulation of Women with Premenstrual Syndrome | Scientific Reports

  https://www.nature.com/articles/srep38501

  Furthermore, some researchers even argue that PMS is not a fixed unitary syndrome but an ongoing process of negotiation, and reframing of symptoms as normal change can effectively reduce premenstrual distress, thus implying the dysfunction of emotion-regulation based on cognitive change among women with PMS. […] The process model of emotion regulation declaimed that emotion may be regulated at different points in the emotion generative process, and emotion-regulation strategies differ in when they have their primary impact on the emotion-generative process. […] According to this model, strategies enacted at different stages of the emotion process rely on different skills and have different consequences for emotional experience, physiology, and behavior. […] Reappraisal and suppression are two commonly used strategies for diminishing negative emotional reactions, which have been extensively operationalized within the model.

• #1 Emotion Dysregulation of Women with Premenstrual Syndrome | Scientific Reports

  https://www.nature.com/articles/srep38501

  Researchers found that habitual emotion regulation may have an impact on individuals well-being and performance in emotion experience tasks. […] The habitual use of reappraisal was related to greater positive affect, better interpersonal functioning, and higher well-being. […] By contrast, greater use of suppression was related to a less beneficial profile of emotional functioning. […] Previous researches showed that cognitive reappraisal leads to the decreased expression of negative emotions and their behaviors, decreased startle responses and attenuated autonomic responses. […] Recent neuroimaging studies also revealed that the greater use of reappraisal in everyday life was related to decreased amygdala activity and increased prefrontal and parietal activity during the processing of negative emotional facial expressions.

• #1 Emotion Dysregulation of Women with Premenstrual Syndrome | Scientific Reports

  https://www.nature.com/articles/srep38501

  The nonlinear correlation between hormonal levels and emotional responding may be the reason why we didn’t find the influence of hormone on emotional responding using linear regression analysis. […] Thus more advanced analysis methods are required to clarify the interactions between sex hormones and emotional responding in the future studies. […] According to our results, women with PMS appear to have a trait-like emotion dysregulation throughout the menstrual cycle. […] Greater use of reappraisal in everyday life is related to less experience of premenstrual symptoms, especially those emotion-related symptoms, whereas greater use of suppression in everyday life is related to higher possibility of experiencing premenstrual symptoms. […] Spontaneous suppression of negative emotions increases physiological arousal of women with PMS, and instructed reappraisal of negative emotions can’t help women with PMS decrease physiological arousal. […] These results help delineate the specific emotion regulation profile associated with PMS.

• #1 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

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

  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. […] Stress amplifies the sympathetic activity, and this results in menstrual pain by significantly increasing the intensity of uterine contraction.

• #1 Premenstrual syndrome, coping mechanisms and associated factors among Wolkite university female regular students, Ethiopia, 2021 | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01658-5

  Students with irregular menstrual cycle were 2.26 times more risky to experience premenstrual syndrome than the counterpart. […] Those students who start menstruation at early age (13 years) were 2.64 times more likely to develop PMS, consistent with a study conducted in Saudi Arabia. […] Those findings indicates that prompt identification and management of menstrual irregularity and providing counseling service for those who started menstruation at early age is crucial to decrease severity of premenstrual symptoms. […] In this study premenstrual syndrome was found to be a problem of many students. […] Family history of PMS, no history of sexual intercourse, intense menstrual pain, using of many pads during menstruation, irregular menstrual cycle, early menarche, and long duration of menses were found to be predictors of premenstrual syndrome.

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

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

  For example, a drop in estrogen may prompt the release of norepinephrine, which leads to declining production of dopamine, acetylcholine, and serotonin. […] Living with a mental health condition, such as depression or anxiety, could raise your chances of experiencing PMS or premenstrual dysphoric disorder (PMDD), a more severe form of PMS. […] Experts have yet to arrive at a conclusive explanation for the link between mental health symptoms and menstruation-related mood changes. […] Certain habits might affect the severity of your PMS symptoms. […] Research from 2018 also links alcohol use to increased risk of PMS. […] As with PMS, PMDD symptoms may occur due to fluctuations in levels of estrogen, progesterone, and serotonin.

• #1 PMS & PMDD – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

  Premenstrual Syndrome, commonly referred to as PMS, is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients. […] Although the etiology of PMS and PMDD remains uncertain at present, researchers now concur that these disorders represent biological phenomena rather than purely psychological events. Recent research indicates that women who are vulnerable to premenstrual mood changes do not have abnormal levels of hormones or some type of hormonal dysregulation, but rather a particular sensitivity to normal cyclical hormonal changes.

• #1 Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder – PubMed

  https://pubmed.ncbi.nlm.nih.gov/22611222/

  However, similar to the affective disorders, PMS is ultimately not likely to be related to the dysregulation of individual neurotransmitters. […] Brain imaging studies have begun to shed light on the complex brain circuitry underlying affect and behaviour and may help to explicate the intricate neurophysiological foundation of the syndrome.

• #1 Premenstrual syndrome: an update on definitions, diagnosis and management | Advances in Psychiatric Treatment | Cambridge Core

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/premenstrual-syndrome-an-update-on-definitions-diagnosis-and-management/036791CDE4A75D5F6F466926D81D907C

  Rapkin (1992) has summarised the role of serotonin in human and animal behaviour and the relevance of this research for the premenstrual syndrome. […] With respect to the influence of gonadal hormones on serotonergic function, most information has come from animal studies and is not always consistent or conclusive. […] However, in general, decreased levels of gonadal hormones are associated with decreased serotonergic activity. […] What is certain is that normal cyclical ovarian function is central to the disorder and abolishing it by either medical or surgical oophorectomy can prove curative. […] It is generally agreed that there is no single biological substrate that can be considered causal in isolation, but a bio-psychosocial model probably best fits the clinical picture and should underpin approaches to treatment.

• #2 PMS & PMDD – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

  Premenstrual Syndrome, commonly referred to as PMS, is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients. […] Although the etiology of PMS and PMDD remains uncertain at present, researchers now concur that these disorders represent biological phenomena rather than purely psychological events. Recent research indicates that women who are vulnerable to premenstrual mood changes do not have abnormal levels of hormones or some type of hormonal dysregulation, but rather a particular sensitivity to normal cyclical hormonal changes.

• #2 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. […] 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. […] 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. […] Studies show that women with PMS exhibit abnormal serotonergic function during the luteal phase.

• #2 Premenstrual dysphoric disorder – Wikipedia

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

  PMDD’s exact cause is unknown. […] But because symptoms are present only during ovulatory cycles and resolve after menstruation, it is believed to be caused by fluctuations in gonadal sex hormones or variations in sensitivity to sex hormones. […] The current consensus on the cause of PMDD is a combination of heightened sensitivity to fluctuating levels of certain hormones (i.e., the reproductive hormones), environmental stress, and genetic predisposition. […] While the timing of symptoms suggests hormonal fluctuations as the cause of PMDD, a demonstrable hormonal imbalance in women with PMDD has not been identified. […] It is instead hypothesized that women with PMDD are more sensitive to normal levels of hormone fluctuations, predominantly estrogen and progesterone, which produces biochemical events in the nervous system that cause the premenstrual symptoms.

• #2 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

  Current evidence suggests that PMS is a disorder triggered by changes in gonadal steroids during the LPMC in susceptible women. […] This is thought to be due to the interaction between cyclic changes in ovarian steroids and the functioning of central neurotransmitters. […] One of the most frequently investigated neurotransmitters in PMS pathogenesis is serotonin, but beta-endorphine, gamma-aminobutyric acid (GABA) and the autonomic nervous system are also part of the pathogenesis of PMS. […] 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 Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder – PubMed

  https://pubmed.ncbi.nlm.nih.gov/22611222/

  Premenstrual syndrome (PMS) and premenstrual dysphoric disorder are triggered by hormonal events ensuing after ovulation. […] Although evidence for a hormonal abnormality has not been established, the symptoms of the premenstrual disorders are related to the production of progesterone by the ovary. […] The two best-studied and relevant neurotransmitter systems implicated in the genesis of the symptoms are the GABArgic and the serotonergic systems. […] Metabolites of progesterone formed by the corpus luteum of the ovary and in the brain bind to a neurosteroid-binding site on the membrane of the gamma-aminobutyric acid (GABA) receptor, changing its configuration, rendering it resistant to further activation and finally decreasing central GABA-mediated inhibition. […] The lowering of serotonin can give rise to PMS-like symptoms and serotonergic functioning seems to be deficient by some methods of estimating serotonergic activity in the brain; agents that augment serotonin are efficacious and are as effective even if administered only in the luteal phase.

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

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

  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]). […] 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. […] Selective serotonin release inhibitors (SSRIs) have been shown in randomized trials to improve mood and lessen physical symptoms such as breast tenderness and changes in appetite.

• #2 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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] 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. […] 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. […] Studies show that women with PMS exhibit abnormal serotonergic function during the luteal phase.

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

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

  For example, a drop in estrogen may prompt the release of norepinephrine, which leads to declining production of dopamine, acetylcholine, and serotonin. […] Living with a mental health condition, such as depression or anxiety, could raise your chances of experiencing PMS or premenstrual dysphoric disorder (PMDD), a more severe form of PMS. […] Experts have yet to arrive at a conclusive explanation for the link between mental health symptoms and menstruation-related mood changes. […] Certain habits might affect the severity of your PMS symptoms. […] Research from 2018 also links alcohol use to increased risk of PMS. […] As with PMS, PMDD symptoms may occur due to fluctuations in levels of estrogen, progesterone, and serotonin.

• #2 Premenstrual dysphoria disorder: It’s biology, not a behavior choice – Harvard Health

  https://www.health.harvard.edu/blog/premenstrual-dysphoria-disorder-its-biology-not-a-behavior-choice-2017053011768

  Broadly speaking, if you have PMDD, you have an increased sensitivity to your reproductive hormones during the two weeks before your period starts. This sensitivity leads to alterations in the brain chemicals and neurologic pathways that control your mood and your general sense of well-being. Exactly what that sensitivity is and what causes it has not been well understood. And treatment options have been limited. […] Researchers at the National Institutes of Health (NIH) have found that women with PMDD have an altered gene complex that processes the body’s response to hormones and stressors. This is a very important discovery, as it establishes a biological basis for the mood disturbances of PMDD. Not only is this validation for women who live with PMDD, but it also has tremendous implications for new and improved treatment options. […] Dr. Peter Schmidt, one of the lead researchers on the NIH study, published data that support the working theory that it is the changes in hormone levels, not just the hormones themselves, that trigger the symptoms of PMDD.

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