Materiały źródłowe

• #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.

• #2 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

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

  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 comprises of three major hormones: estrone, estradiol, estriol, estradiol being the is the most potent. Estrogen levels that fluctuate during the luteal phase are what is responsible for womens mood changes. Clinical trials have shown that serotonin precursors significantly increases 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.

• #3 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. […] 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.

• #4 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. […] What causes PMS? […] 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.

• #5 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 do not know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. […] PMS 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. […] PMS stops after menopause when you no longer get a period.

• #6 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. […] It’s not clear what causes PMDD, but it’s been linked to being very sensitive to changes in hormones, or certain differences in the genes you inherit from your parents.

• #7 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. Premenstrual dysphoric disorder (PMDD) is the severe form of PMS. […] 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.

• #8 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.

• #9 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 disorder’s etiology. […] Hormonal changes, stress, diet, and alterations in neurotransmission are considered the most significant risk factors. […] 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.

• #10 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 disorder’s etiology. […] Hormonal changes, stress, diet, and alterations in neurotransmission are considered the most significant risk factors. […] 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.

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

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

  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. […] The dysregulation of the HPA axis may be caused by cyclical stressors experienced over time. […] In the context of the etiology of PMS, the role of prolactin was also considered.

• #12 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.

• #13 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.

• #14 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

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

  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 comprises of three major hormones: estrone, estradiol, estriol, estradiol being the is the most potent. Estrogen levels that fluctuate during the luteal phase are what is responsible for womens mood changes. Clinical trials have shown that serotonin precursors significantly increases 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.

• #15 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.

• #16 Premenstrual syndrome (PMS): What it is, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/325314

  Premenstrual syndrome (PMS) refers to the physical and psychological symptoms that a person may experience before their menstrual period. […] The exact cause of PMS remains unknown. However, natural fluctuations in hormone levels, especially those of estrogen and progesterone, in the week or two before menstruation are likely responsible for the symptoms. […] Estrogen and progesterone levels decrease dramatically after ovulation. This could play a major role in the development of PMS symptoms. […] The drop in estrogen levels may affect a persons serotonin levels. Serotonin is a brain chemical that helps regulate mood, sleep, and appetite, all of which PMS affects. […] Most females experience at least one symptom of PMS. Fluctuations in hormone levels might play a significant role in PMS, but the exact cause remains unknown. […] A small percentage of people can develop a severe form of PMS called PMDD.

• #17 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. […] This chemical regulates moods and those with disturbances of serotonin may develop mood disturbances and depression associated with PMS.

• #18 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 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. […] The two best-studied neurotransmitter systems involved in the formation of symptoms are the GABAergic and serotonergic systems. […] 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.

• #19 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.

• #20 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.

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

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

  Studies with bromocriptine provide indirect evidence for the effect of prolactin on PMS. […] 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.

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

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

  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. […] 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. […] A family history of PMS, bipolar disorder, or depression, including postpartum depression, can also increase this risk. […] Certain habits might affect the severity of your PMS symptoms. Potential lifestyle factors that could worsen PMS symptoms include: smoking, eating a lot of foods high in fat, sugar, and salt, a lack of regular physical activity, a lack of quality sleep. […] Research from 2018 also links alcohol use to increased risk of PMS. If you binge drink or drink heavily on a regular basis, you’re even more likely to experience PMS symptoms.

• #23 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0801/p236.html

  Premenstrual disorders consist of psychiatric or somatic symptoms that develop within the luteal phase of the menstrual cycle, affect the patient’s normal daily functioning, and resolve shortly after menstruation. […] There is a poor understanding of the etiology of premenstrual disorders. Several studies suggest that cyclical changes in estrogen and progesterone levels trigger the symptoms. […] Changes in mood may be attributable to the effect estrogen and progesterone have on the serotonin, -aminobutyric acid, and dopamine systems. […] Sex hormone levels alone cannot fully explain premenstrual disorders. Studies show that women diagnosed with a premenstrual disorder do not have higher levels of estrogen or progesterone than the general population, and accepted explanations as to why some women could be more sensitive to fluctuations in these sex hormones are lacking. […] Monozygotic twin studies suggest a possible genetic component to premenstrual disorders; however, no genes have been identified.

• #24 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

  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, and the FF genotype, which is common among Arab women, has a higher risk. […] Similarly, PMS has been linked to temporal-limbic system (TLS) abnormalities that are inherited or acquired at an early age. […] Furthermore, a study found that 56% of PMS is inherited, and women with PMDD may have distinct biological responses to ovarian steroids. […] According to some studies, the estrogen receptor 1 (ESR1) gene promotes vulnerability to PMDD, and the ESR1 polymorphism causes sensitivity to changes in estrogen receptor signaling and other physiological gonadal hormone alterations. […] The etiology of PMS is associated with cognitive and psychosocial learning theories. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #25

  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. […] 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. […] It is highly necessary to examine biological, psychological, and social etiologies of PMS, and discussion of more intellectual and diverse approaches is needed. […] An increase in the level of gonadal hormones and their fluctuations may not be the only cause of PMS but might intensify the results of the symptoms in hormone-sensitive individuals.

• #26 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.

• #27 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.

• #28 Premenstrual Syndrome (PMS) | ACOG

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

  Taking 1,200 milligrams (mg) of calcium a day can help reduce the physical and mood symptoms that are part of PMS. Taking magnesium supplements may help reduce water retention („bloating”), breast tenderness, and mood symptoms. […] Drugs that prevent ovulation, such as hormonal birth control methods, may lessen physical symptoms. But not all may relieve the mood symptoms of PMS. […] Antidepressants can be helpful in treating PMS in some women. These drugs can help lessen mood symptoms.

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

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

  Premenstrual syndrome (PMS) is a group of physical and psychologic symptoms that start several days before a menstrual period begins and usually end a few hours after the first day of a period. […] 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. […] Some women may have a genetic make-up that makes them more susceptible to PMS. […] 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. […] A deficiency of magnesium or calcium may contribute. […] 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.

• #30 Premenstrual Syndrome | PMS | PMS Symptoms | MedlinePlus

  https://medlineplus.gov/premenstrualsyndrome.html

  Premenstrual syndrome, or PMS, is a group of physical and emotional symptoms that start one to two weeks before your period. […] Researchers don’t know exactly what causes PMS. Changes in hormone levels during the menstrual cycle may play a role. […] Some studies have shown that certain vitamins may help with some symptoms of PMS. They include calcium and vitamin B6.

• #31 Azthena logo with the word Azthena

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

  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 […] Excessive emotional stress, anxiety etc. may lead to aggravated symptoms of PMS.

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

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

  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. […] The dysregulation of the HPA axis may be caused by cyclical stressors experienced over time. […] In the context of the etiology of PMS, the role of prolactin was also considered.

• #33 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.

• #34 Premenstrual Syndrome (PMS) – Harvard Health

  https://www.health.harvard.edu/a_to_z/premenstrual-syndrome-pms-a-to-z

  Premenstrual syndrome (PMS) is a collection of symptoms that many women experience during the several days and sometimes longer before a menstrual period. Researchers are not certain what causes PMS. The most popular explanation is that PMS symptoms are related to cyclic changes in: female sex hormones, pituitary hormones, prostaglandins, certain brain chemicals (neurotransmitters). […] However, it’s not clear whether these factors increase your risk of PMS or if PMS accounts for these differences in lifestyle. For example, it is more likely that PMS causes stress rather than that stress causes PMS. […] The treatment of PMS depends on: the severity and type of symptoms, how bothersome they are. […] In most women, PMS symptoms begin to subside after age 35. They end at menopause. Women who have PMS or PMDD are at greater risk of developing depression.

• #35 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. […] The mental, neurological, and endocrine systems all have a role in the etiology of PMS. […] 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.

• #36 Beyond bloating and mood swings: your guide to premenstrual dysphoric disorder (PMDD) and why it’s more than just premenstrual syndrome (PMS) | Queensland Health

  https://www.health.qld.gov.au/newsroom/features/breaking-the-cycle-a-guide-to-understanding-and-managing-premenstrual-dysphoric-disorder-pmdd

  Mood disorders: if you or a family member has depression, anxiety, or other mood disorders, you may be more likely to experience PMDD. […] Early childhood trauma: research suggests that 83% of Australians with PMDD had experienced trauma early in life. […] PMDD can sometimes be misdiagnosed as some PMDD symptoms mimic other conditions. […] With PMDD, symptoms overlapping with these disorders occur only on the days between ovulation and the end of a period. […] PMDD may cause the following symptoms: extreme or sudden mood changes and emotional sensitivity, irritability or anger, depressed mood — feeling hopeless, worthless, or guilty, anxiety, tension, or feeling on edge. […] A PMDD diagnosis can only be made if someone has at least five symptoms for two or more menstrual cycles.

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

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

  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.

• #38 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

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

  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. […] Cheng et al. did a similar study among women university students for assessing the factors associated with PMS and revealed that dietary factors such as consumption of fast food, drinks containing sugar, deep-fried foods, and lifestyle factors such as less habitual exercise and poor sleep quality is significantly associated with PMS.

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

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

  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. […] 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. […] A family history of PMS, bipolar disorder, or depression, including postpartum depression, can also increase this risk. […] Certain habits might affect the severity of your PMS symptoms. Potential lifestyle factors that could worsen PMS symptoms include: smoking, eating a lot of foods high in fat, sugar, and salt, a lack of regular physical activity, a lack of quality sleep. […] Research from 2018 also links alcohol use to increased risk of PMS. If you binge drink or drink heavily on a regular basis, you’re even more likely to experience PMS symptoms.

• #40 Premenstrual syndrome (PMS) Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/premenstrual-syndrome-pms.html

  Premenstrual syndrome (PMS) is a collection of symptoms that many women experience during the several days and sometimes longer before a menstrual period. These symptoms may be physical, psychological and emotional. They disappear soon after the start of menstrual bleeding. […] Researchers are not certain what causes PMS. The most popular explanation is that PMS symptoms are related to cyclic changes in: female sex hormones, pituitary hormones, prostaglandins, certain brain chemicals (neurotransmitters). […] Lifestyle may play a significant role in PMS. PMS symptoms appear to be most troubling in women who: smoke, lead stressful lives, rarely exercise, sleep too little, have a diet high in caffeine, alcohol, salt, red meat, sugary foods. […] However, it’s not clear whether these factors increase your risk of PMS or if PMS accounts for these differences in lifestyle.

• #41 A Visual Guide to Premenstrual Syndrome (PMS)

  https://www.webmd.com/women/pms/ss/slideshow-premenstrual-syndrome-pms

  What Causes PMS? The exact cause of PMS is not clear, but we do know that levels of estrogen and progesterone drop during the week before your period. Many doctors believe this decline in hormone levels triggers the symptoms of PMS. Changes in brain chemicals or deficiencies in certain vitamins and minerals may also play a role. Too many salty foods, alcohol, or caffeine may make symptoms worse as well.

• #42 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. […] 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. […] Cigarette smoking is linked to an increased risk of severe PMS and PMDD. […] Researchers tracked more than 3,000 women ages 27 to 44 over 10 years and found that those with a history of smoking were twice as likely to develop PMS than those who never smoked.

• #43 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

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

  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. […] Cheng et al. did a similar study among women university students for assessing the factors associated with PMS and revealed that dietary factors such as consumption of fast food, drinks containing sugar, deep-fried foods, and lifestyle factors such as less habitual exercise and poor sleep quality is significantly associated with PMS.

• #44 Investigating influencing factors on premenstrual syndrome (PMS) among female college students | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02752-y

  PMS was associated positively with depression, stress, sleep disturbance, and eating attitude problems. […] Additionally, menstrual pain intensity, sleep disturbances, and eating attitude problems were found to influence PMS. […] The regression model was significant with an explanatory power of 24.7%. […] Stress from COVID-19 can disrupt glucocorticoid hormone levels and affect menstrual cycle regularity. […] Among such negative emotions, stress can further exacerbate emotional and psychological symptoms associated with PMS. […] Depression is known to have the highest influence on PMS. […] Women experiencing PMS are particularly susceptible to sleep disturbances due to hormonal changes associated with the menstrual cycle. […] Eating attitude problems have been linked to PMS, and differences in appetite and eating habits are observed between healthy women and those with PMS. […] More serious eating attitude problems were found to be associated with higher levels of PMS, and eating attitude problems were thus identified as the third determinant of PMS level.

• #45 Factors Associated with Premenstrual Syndrome and its Different Symptom Domains among University Students in Lebanon

  https://www.clinmedjournals.org/articles/ijwhw/international-journal-of-womens-health-and-wellness-ijwhw-4-068.php

  Premenstrual syndrome (PMS) is characterized by affective and somatic symptoms appearing in the days preceding menses and interfering with women’s daily life. The etiology of PMS has not yet been clearly elucidated. Genetic, environmental, and psychological factors could impact hormonal fluctuations and thus lead to PMS symptoms. Cyclical ovarian activity and the effect of estradiol and progesterone on the neurotransmitters like serotonin and gamma-amino butyric acid (GABA) appear to play key roles. Absence of PMS before puberty, during pregnancy and after the menopause supports the theory that cyclical ovarian activity is important in PMS development. […] PMS etiology is multifactorial. PMS was positively associated with increasing BMI in this study. A cross-sectional study conducted among 874 women aged 18 to 44 reported that obese women had almost a three-fold increased risk for PMS compared to underweight women. Furthermore, another prospective study conducted among women free from PMS at baseline found that obese women at baseline had significantly higher risks of developing PMS over 10 years of follow-up. It is thought that obesity modifies neurotransmitter function through its effect on estrogen and progesterone. Estrogen enhances serotonin action by increasing its synthesis, transport, reuptake and receptor expression, and postsynaptic responsiveness. Therefore, lower estradiol levels associated with adiposity may lead to impaired serotonin function and contribute to the occurrence of PMS.

• #46 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

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

  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. […] Cheng et al. did a similar study among women university students for assessing the factors associated with PMS and revealed that dietary factors such as consumption of fast food, drinks containing sugar, deep-fried foods, and lifestyle factors such as less habitual exercise and poor sleep quality is significantly associated with PMS.

• #47 Investigating influencing factors on premenstrual syndrome (PMS) among female college students | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02752-y

  PMS was associated positively with depression, stress, sleep disturbance, and eating attitude problems. […] Additionally, menstrual pain intensity, sleep disturbances, and eating attitude problems were found to influence PMS. […] The regression model was significant with an explanatory power of 24.7%. […] Stress from COVID-19 can disrupt glucocorticoid hormone levels and affect menstrual cycle regularity. […] Among such negative emotions, stress can further exacerbate emotional and psychological symptoms associated with PMS. […] Depression is known to have the highest influence on PMS. […] Women experiencing PMS are particularly susceptible to sleep disturbances due to hormonal changes associated with the menstrual cycle. […] Eating attitude problems have been linked to PMS, and differences in appetite and eating habits are observed between healthy women and those with PMS. […] More serious eating attitude problems were found to be associated with higher levels of PMS, and eating attitude problems were thus identified as the third determinant of PMS level.

• #48 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.

• #49 Premenstrual Syndrome (PMS) – Harvard Health

  https://www.health.harvard.edu/a_to_z/premenstrual-syndrome-pms-a-to-z

  Premenstrual syndrome (PMS) is a collection of symptoms that many women experience during the several days and sometimes longer before a menstrual period. Researchers are not certain what causes PMS. The most popular explanation is that PMS symptoms are related to cyclic changes in: female sex hormones, pituitary hormones, prostaglandins, certain brain chemicals (neurotransmitters). […] However, it’s not clear whether these factors increase your risk of PMS or if PMS accounts for these differences in lifestyle. For example, it is more likely that PMS causes stress rather than that stress causes PMS. […] The treatment of PMS depends on: the severity and type of symptoms, how bothersome they are. […] In most women, PMS symptoms begin to subside after age 35. They end at menopause. Women who have PMS or PMDD are at greater risk of developing depression.

• #50 Beyond bloating and mood swings: your guide to premenstrual dysphoric disorder (PMDD) and why it’s more than just premenstrual syndrome (PMS) | Queensland Health

  https://www.health.qld.gov.au/newsroom/features/breaking-the-cycle-a-guide-to-understanding-and-managing-premenstrual-dysphoric-disorder-pmdd

  Mood disorders: if you or a family member has depression, anxiety, or other mood disorders, you may be more likely to experience PMDD. […] Early childhood trauma: research suggests that 83% of Australians with PMDD had experienced trauma early in life. […] PMDD can sometimes be misdiagnosed as some PMDD symptoms mimic other conditions. […] With PMDD, symptoms overlapping with these disorders occur only on the days between ovulation and the end of a period. […] PMDD may cause the following symptoms: extreme or sudden mood changes and emotional sensitivity, irritability or anger, depressed mood — feeling hopeless, worthless, or guilty, anxiety, tension, or feeling on edge. […] A PMDD diagnosis can only be made if someone has at least five symptoms for two or more menstrual cycles.

• #51 Premenstrual dysphoric disorder – Wikipedia

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

  Most psychologists infer that this disorder is caused by both a reaction to hormone flux and also genetic components. […] There is evidence of heritability of (retrospectively reported) premenstrual symptoms from several twin and family studies done in the 1990s, with the heritability of PMDD proving to be about 56%. […] Environmental stressors have also been found to increase the risk for PMDD symptoms prospectively. […] Some studies have noted evidence of interpersonal trauma (domestic violence, physical or emotional trauma, or substance use) or seasonal changes (making PMDD potentially comorbid with seasonal affective disorder) having an impact on PMDD risk. […] The most common pre-existing disorder found in those diagnosed with PMDD is major depression, wherein they either had it or were misdiagnosed when they should have only been diagnosed with PMDD.

• #52 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.

• #53 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.

• #54 Premenstrual Dysphoric Disorder (PMDD): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/9132-premenstrual-dysphoric-disorder-pmdd

  Premenstrual dysphoric disorder (PMDD) is a more serious form of premenstrual syndrome (PMS). It causes physical and emotional symptoms every menstrual cycle in the week or two before your period. PMS causes bloating, headaches and breast tenderness. […] Experts dont know why some people get PMDD. Decreasing levels of estrogen and progesterone hormones after ovulation and before menstruation may trigger symptoms. Serotonin, a brain chemical that regulates mood, hunger and sleep, may also play a role. Serotonin levels, like hormone levels, change throughout your menstrual cycle. […] PMDD and PMS are similar in that they both happen in the week or two before your period begins when your hormone levels drop. They both cause physical symptoms like cramps, headaches or bloating. However, PMDD also causes serious symptoms that may disrupt your mood.

• #55 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.

• #56 Premenstrual dysphoric disorder – Wikipedia

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

  Most psychologists infer that this disorder is caused by both a reaction to hormone flux and also genetic components. […] There is evidence of heritability of (retrospectively reported) premenstrual symptoms from several twin and family studies done in the 1990s, with the heritability of PMDD proving to be about 56%. […] Environmental stressors have also been found to increase the risk for PMDD symptoms prospectively. […] Some studies have noted evidence of interpersonal trauma (domestic violence, physical or emotional trauma, or substance use) or seasonal changes (making PMDD potentially comorbid with seasonal affective disorder) having an impact on PMDD risk. […] The most common pre-existing disorder found in those diagnosed with PMDD is major depression, wherein they either had it or were misdiagnosed when they should have only been diagnosed with PMDD.

• #57 Premenstrual Dysphoric Disorder (PMDD): Symptoms, Treatment, and More

  https://www.verywellmind.com/premenstrual-dysphoric-disorder-4767096

  Premenstrual dysphoric disorder is thought to be caused by gene alterations that result in a greater sensitivity to sex hormones that influence mood and well-being. […] The cause of PMDD is complex. According to research published in 2022, individuals with this condition appear to have a genetic sensitivity to the sex hormone allopregnanolone combined with the neurotransmitter serotonin being less available, and ovarian reproductive steroids may play a role as well. […] Other evidence supports the role of reproductive steroids in PMDD. More specifically, a different study noted that PMDD may be related to alterations in the cellular responses involved in the metabolism of the reproductive steroids estrogen and progesterone. […] One’s environment can also have an impact on how PMDD appears. For example, research has shown that experiencing high levels of stress can increase the severity of this condition.

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

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

  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. […] The efficacy of selective serotonin reuptake inhibitors (SSRIs) for treating PMDD could be the result of the interaction of these medications with neuroactive steroids, possibly because SSRIs enhance the sensitivity of GABAA receptors or promote the formation of more ALLO. […] The link between a history of stress, trauma, and PMDD raises the question of biologic resiliency and illness in these patients, as it connects to the HPA and HPG axis and production of inflammatory stress hormones and steroid hormones and their metabolites. PMDD can be conceptualized as variable sensitivity to hormonal response to stress, thus contextualizing biochemical and psychological resiliency. […] The etiology of PMDD is complex. PMDD may be a disorder of withdrawal caused by a transient decline in neurosteroids.

• #59 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

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

• #60

  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. […] 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. […] It is highly necessary to examine biological, psychological, and social etiologies of PMS, and discussion of more intellectual and diverse approaches is needed. […] An increase in the level of gonadal hormones and their fluctuations may not be the only cause of PMS but might intensify the results of the symptoms in hormone-sensitive individuals.

• #61 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

  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, and the FF genotype, which is common among Arab women, has a higher risk. […] Similarly, PMS has been linked to temporal-limbic system (TLS) abnormalities that are inherited or acquired at an early age. […] Furthermore, a study found that 56% of PMS is inherited, and women with PMDD may have distinct biological responses to ovarian steroids. […] According to some studies, the estrogen receptor 1 (ESR1) gene promotes vulnerability to PMDD, and the ESR1 polymorphism causes sensitivity to changes in estrogen receptor signaling and other physiological gonadal hormone alterations. […] The etiology of PMS is associated with cognitive and psychosocial learning theories. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #62 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.

• #63 Premenstrual syndrome | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/premenstrual-syndrome/

  Premenstrual syndrome (PMS) is a condition that affects women during the days leading up to her monthly period; it can cause distressing physical and emotional symptoms. […] The exact cause of premenstrual syndrome is not known however hormonal changes are thought to trigger the symptoms. After ovulation, when the corpus luteum begins to break down, the decline in progesterone levels towards the end of the menstrual cycle affects various chemicals in the brain. Women with premenstrual syndrome do not have abnormal levels of hormones but they appear to be more sensitive to the effects of progesterone and oestrogen. […] Early research has suggested that there may be a genetic predisposition to developing premenstrual syndrome; however, this has not been proven. More research is needed to clarify whether premenstrual syndrome runs in families.

• #64 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 following post was first published in Current Psychiatry, published September 2017, Vol. 16, No. 9, p. 20-28. Check out the article on Current Psychiatry or listen to Dr. Raffi discuss treatment of menstrual-related mood and anxiety disorders. […] In an age when psychiatry strives to identify the biologic causes of disease, studying endocrine-related mood disorders is particularly intriguing. DSM-5 defines premenstrual dysphoric disorder (PMDD) as a depressive disorder, with a 12-month prevalence ranging from 1.8% to 5.8% among women who menstruate. Factors that differentiate PMDD from other affective disorders include etiology, duration, and temporal relationship with the menstrual cycle. […] This article summarizes what is known about the etiology of PMDD. Although there are several treatments for PMDD, many women experience adverse effects or incomplete effectiveness. Further understanding of this disorder may lead to more efficacious treatments. Additionally, understanding the pathophysiology of PMDD might shed a light on the etiology of other disorders that are temporally related to reproductive life changes, such as pregnancy-, postpartum-, or menopause-related affective dysregulation.

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

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

  Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) encompass a variety of symptoms that occur during the luteal phase of the menstrual cycle and impair daily life activities and relationships. […] PMS and PMDD are common neuro-hormonal gynecological disorders with a multifaceted etiology. […] A more sensitive neuroendocrine threshold to cyclical variations of estrogens and progesterone under physiological and hormonal therapies is present. […] Moreover, altered brain sensitivity to allopregnanolone, a metabolite of progesterone produced after ovulation potentiating GABA activity, along with an impairment of opioid and serotoninergic systems, may justify the occurrence of emotional and behavioral symptoms. […] Even neuro-inflammation expressed via the GABAergic system is under investigation as an etiological factor of PMS/PMDD.

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