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.

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

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

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

• #3 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. […] Likewise, endocrine system assumption is used to explain the PMS physiopathological process. […] In the hormonal etiology of PMDD, physiological changes in gonadal hormones are thought to trigger central neurochemical reactions that reveal symptoms.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

• #5 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.

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

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

  Premenstrual Syndrome (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. […] 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. […] 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.

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

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

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

• #8 Premenstrual Syndrome (PMS, PMT) | Symptoms and Treatment

  https://patient.info/womens-health/periods-and-period-problems/premenstrual-syndrome

  Premenstrual syndrome (PMS) is when symptoms cause significant personal, interpersonal or functional problems. […] The cause is not known. It is not due to imbalanced hormone levels, or due to too much or too little of any hormone (as was previously thought). However, the release of an egg from an ovary each month (ovulation) appears to trigger symptoms. It is thought that women with PMS are more sensitive to the normal level of progesterone. This hormone is passed into the bloodstream from the ovaries after you ovulate. […] One effect of over-sensitivity to progesterone seems to reduce the level of brain chemicals (neurotransmitters) called serotonin and gamma-aminobutyric acid (GABA). This may lead to symptoms, and may explain why medicines that increase the level of the brain chemical serotonin work in PMS.

• #9 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. […] Current evidence suggests that PMS is a disorder triggered by changes in gonadal steroids during the LPMC in susceptible women. […] 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. […] The potential role of the GABAergic system in PMS has not been extensively investigated previously. […] 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.

• #10 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.

• #11 Premenstrual Syndrome | AAFP

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

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

• #12 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.

• #13 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.

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

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

  Premenstrual Syndrome (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. […] 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. […] 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.

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

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

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

• #16 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #17 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.

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

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

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

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

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

  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 A 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 Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders

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

  An 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. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

• #21 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 changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Changes in mRNA expression of serotonin receptors 5-HT1A and 5-HT2A, GABAARs, and central monoamine neurotransmitter receptors, including ER and ERb, progesterone receptors, and central steroidal hormone receptors, were seen in the limbic system of a macaque model with PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] 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.

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

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

  An 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. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

• #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. […] Guidelines from the International Society of Premenstrual Disorders addressed gonadotropin-releasing hormone agonists as potential treatment of PMS and PMDD by eliminating luteal phase symptoms.

• #24 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.

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

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

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

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

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

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

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

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

  Our finding that the emotion dysregulation of women with PMS existed throughout the entire menstrual cycle also supports this idea. […] Overall, studies that have investigated women during different phases of the menstrual cycle suggest that progesterone increases amygdala reactivity, whereas estrogen may have the opposite effect on amygdala reactivity. […] 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.

• #28 The Etiology of Premenstral Dysphoric Disorder: 5 interwoven pieces. – MGH Center for Women’s Mental Health

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

  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 etiology of PMDD is complex. PMDD may be a disorder of withdrawal caused by a transient decline in neurosteroids.

• #29 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 etiology of PMS is associated with cognitive and psychosocial learning theories. […] Functions of the CNS, abnormal responses to normal hormonal changes, changes in GM volume in the brain, differences in activities in the resting state of the brain, abnormalities in the limbic system, causes of disturbances in emotion processing and regulation, genetic predispositions and their explanations, and the role of nutrition, mineral, and vitamin intake were presented to shed light on the mechanism. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #30 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 fractional amplitude of low-frequency fluctuations (fALFF) is a data-driven method that is thought to reflect the intensity of spontaneous activity in the resting state of the brain. […] In conclusion, current brain studies were reviewed in this study to understand the etiology of PMS. 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.

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

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

  Few studies to date evaluated the correlations between PMS and emotion regulation. […] Our findings in Study 1 provide further evidence for this idea. […] Habitual emotion regulation may influence women’s premenstrual affect and physiological responses. […] This result suggests that an intervention of habitual emotion regulation may help to relieve PMS. […] Although we did not find group differences in self-reported spontaneous emotion regulation, the results of the regression analysis may indicate that spontaneous suppression has a greater impact on women with PMS than those without PMS. […] In our current work, the implementation of an adaptive emotion-regulation strategy (i.e. reappraisal) seemed to help women with PMS decrease subjective negative emotions, but have nothing to do with their physiological arousal, which can be seen as the specific emotion profile associated with PMS.

• #32 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.

• #33 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. […] Likewise, endocrine system assumption is used to explain the PMS physiopathological process. […] In the hormonal etiology of PMDD, physiological changes in gonadal hormones are thought to trigger central neurochemical reactions that reveal symptoms.

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

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

  Premenstrual syndrome (PMS) is a set of emotional and physical symptoms that typically occur up to 5 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when menstruation begins, or shortly thereafter. […] 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. Hormonal levels seem to be the same in women whether or not they have PMS. It is possible that women with PMS are somehow more sensitive to these changing levels of hormones. […] 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: […] 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.

• #35 The Etiology of Premenstral Dysphoric Disorder: 5 interwoven pieces. – MGH Center for Women’s Mental Health

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

  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 etiology of PMDD is complex. PMDD may be a disorder of withdrawal caused by a transient decline in neurosteroids.

• #36 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. […] Likewise, endocrine system assumption is used to explain the PMS physiopathological process. […] In the hormonal etiology of PMDD, physiological changes in gonadal hormones are thought to trigger central neurochemical reactions that reveal symptoms.

• #37 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.

• #38 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.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

• #40 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #41 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #42 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.

• #43 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 changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Changes in mRNA expression of serotonin receptors 5-HT1A and 5-HT2A, GABAARs, and central monoamine neurotransmitter receptors, including ER and ERb, progesterone receptors, and central steroidal hormone receptors, were seen in the limbic system of a macaque model with PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] 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.

• #44 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 changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Changes in mRNA expression of serotonin receptors 5-HT1A and 5-HT2A, GABAARs, and central monoamine neurotransmitter receptors, including ER and ERb, progesterone receptors, and central steroidal hormone receptors, were seen in the limbic system of a macaque model with PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] 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.

• #45 The Etiology of Premenstral Dysphoric Disorder: 5 interwoven pieces. – MGH Center for Women’s Mental Health

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

  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.

• #46 Premenstrual dysphoric disorder – Wikipedia

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

  These symptoms are more predominant in women with a predisposition to the disorder. […] It is apparent that premenstrual disorders are biologically driven and are not only psychological or cultural phenomena. […] 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%.

• #47 Relationships between Premenstrual Syndrome (PMS) and Diet Composition, Dietary Patterns and Eating Behaviors

  https://www.mdpi.com/2072-6643/16/12/1911

  The pathogenesis of PMS remains unclear. Changes in sex steroid levels, especially progesterone, and in central neurotransmitters including serotonin, gamma-aminobutyric acid (GABA), glutamate, and beta-endorphins, play an important role in PMS pathogenesis. […] In addition to family predispositions, diet and nutritional deficiencies can participate in the development of PMS. […] The associations between diet composition and the occurrence of PMS and its severity were suggested in some studies. In addition, changes in dietary patterns and eating behaviors were observed in women with PMS. Therefore, the aim of this manuscript is to analyze the available data on the relationship between PMS and diet composition, dietary patterns, and eating behaviors.

• #48 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.

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

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

  Magnesium and calcium deficiencies may contribute. […] In PMDD, symptoms occur regularly and only during the 2nd half of the menstrual cycle; symptoms end with menses or shortly after. […] PMDD is severely distressing, disabling, and often underdiagnosed. […] 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. […] SSRIs are the medications of choice for relief of anxiety, irritability, and other emotional symptoms, particularly if stress cannot be avoided. […] For some women, hormonal manipulation is effective. […] Rarely, for very severe or refractory symptoms, a gonadotropin-releasing hormone (GnRH) agonist (eg, leuprolide 3.75 mg IM, goserelin 3.6 mg subcutaneously every month) with low-dose estrogen/progestin is given to minimize cyclic fluctuations.

• #50 Premenstrual Syndrome | AAFP

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

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

• #51 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.

• #52 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]). […] 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.

• #53 Premenstrual Syndrome (PMS) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/pms

  Premenstrual syndrome seems to be related to fluctuations in estrogen and progesterone in the body during the menstrual cycle. […] Suggested causes of PMS include: estrogen-progesterone imbalance, hyperprolactinemia (an excessive secretion of prolactin, the hormone that stimulates breast development), excessive aldosterone, or ADH (hormone that helps to regulate the metabolism of sodium, chloride, and potassium), carbohydrate metabolism changes, retention of sodium and water by the kidneys, low blood sugar, allergy to progesterone, psychogenic factors.

• #54 Relationships between Premenstrual Syndrome (PMS) and Diet Composition, Dietary Patterns and Eating Behaviors

  https://www.mdpi.com/2072-6643/16/12/1911

  The pathogenesis of PMS remains unclear. Changes in sex steroid levels, especially progesterone, and in central neurotransmitters including serotonin, gamma-aminobutyric acid (GABA), glutamate, and beta-endorphins, play an important role in PMS pathogenesis. […] In addition to family predispositions, diet and nutritional deficiencies can participate in the development of PMS. […] The associations between diet composition and the occurrence of PMS and its severity were suggested in some studies. In addition, changes in dietary patterns and eating behaviors were observed in women with PMS. Therefore, the aim of this manuscript is to analyze the available data on the relationship between PMS and diet composition, dietary patterns, and eating behaviors.

• #55 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.

• #56 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 etiology of PMS is associated with cognitive and psychosocial learning theories. […] Functions of the CNS, abnormal responses to normal hormonal changes, changes in GM volume in the brain, differences in activities in the resting state of the brain, abnormalities in the limbic system, causes of disturbances in emotion processing and regulation, genetic predispositions and their explanations, and the role of nutrition, mineral, and vitamin intake were presented to shed light on the mechanism. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #57 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.

• #58 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. […] Based on these findings, emotion dysregulation has long been thought to be a vulnerability factor for mood disorders. […] However, little information is available regarding the impact of the emotion regulation on women with PMS.

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

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

  Few studies to date evaluated the correlations between PMS and emotion regulation. […] Our findings in Study 1 provide further evidence for this idea. […] Habitual emotion regulation may influence women’s premenstrual affect and physiological responses. […] This result suggests that an intervention of habitual emotion regulation may help to relieve PMS. […] Although we did not find group differences in self-reported spontaneous emotion regulation, the results of the regression analysis may indicate that spontaneous suppression has a greater impact on women with PMS than those without PMS. […] In our current work, the implementation of an adaptive emotion-regulation strategy (i.e. reappraisal) seemed to help women with PMS decrease subjective negative emotions, but have nothing to do with their physiological arousal, which can be seen as the specific emotion profile associated with PMS.

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

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

  Our finding that the emotion dysregulation of women with PMS existed throughout the entire menstrual cycle also supports this idea. […] Overall, studies that have investigated women during different phases of the menstrual cycle suggest that progesterone increases amygdala reactivity, whereas estrogen may have the opposite effect on amygdala reactivity. […] 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.

• #61 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.

• #62 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 etiology of PMS is associated with cognitive and psychosocial learning theories. […] Functions of the CNS, abnormal responses to normal hormonal changes, changes in GM volume in the brain, differences in activities in the resting state of the brain, abnormalities in the limbic system, causes of disturbances in emotion processing and regulation, genetic predispositions and their explanations, and the role of nutrition, mineral, and vitamin intake were presented to shed light on the mechanism. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #63 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

  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 central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] 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.

• #64 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.

• #65 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. […] 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.

• #66 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. Gonadal steroid hormones and their metabolites influence a plethora of biological systems involved in the occurrence of specific symptoms, but there is no doubt that PMS/PMDD are centrally based disorders. […] 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.

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

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

  Our finding that the emotion dysregulation of women with PMS existed throughout the entire menstrual cycle also supports this idea. […] Overall, studies that have investigated women during different phases of the menstrual cycle suggest that progesterone increases amygdala reactivity, whereas estrogen may have the opposite effect on amygdala reactivity. […] 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.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

• #69 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.

• #70 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.

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

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

  Fluid retention may be relieved by reducing sodium intake and taking a diuretic just before symptoms are expected. […] In women with severe symptoms, bilateral oophorectomy may alleviate symptoms because it eliminates menstrual cycles; hormone replacement therapy is then indicated until about age 51 (the average for menopause).

• #72 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.

• #73 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 changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Changes in mRNA expression of serotonin receptors 5-HT1A and 5-HT2A, GABAARs, and central monoamine neurotransmitter receptors, including ER and ERb, progesterone receptors, and central steroidal hormone receptors, were seen in the limbic system of a macaque model with PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] 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.

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

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

  An 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. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

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

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

  Premenstrual Syndrome (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. […] 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. […] 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.

• #77 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. […] Current evidence suggests that PMS is a disorder triggered by changes in gonadal steroids during the LPMC in susceptible women. […] 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. […] The potential role of the GABAergic system in PMS has not been extensively investigated previously. […] 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.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

• #80 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.

• #81 The Etiology of Premenstral Dysphoric Disorder: 5 interwoven pieces. – MGH Center for Women’s Mental Health

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

  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 etiology of PMDD is complex. PMDD may be a disorder of withdrawal caused by a transient decline in neurosteroids.

• #82 Premenstrual dysphoric disorder – Wikipedia

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

  PMDD’s exact cause is unknown. Ovarian hormone levels during the menstrual cycle do not differ between those with PMDD and the general population. […] 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.

• #83 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 etiology of PMS is associated with cognitive and psychosocial learning theories. […] Functions of the CNS, abnormal responses to normal hormonal changes, changes in GM volume in the brain, differences in activities in the resting state of the brain, abnormalities in the limbic system, causes of disturbances in emotion processing and regulation, genetic predispositions and their explanations, and the role of nutrition, mineral, and vitamin intake were presented to shed light on the mechanism. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

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

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

  Premenstrual Syndrome (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. […] 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. […] 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.

• #85 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?jid=ijwhw

  This study aimed to estimate the prevalence and examine the characteristics of premenstrual syndrome (PMS) among female university students. It also aimed to determine the factors associated with the affective and somatic domains of PMS. […] 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. […] The proportion of Lebanese females with PMS and affective and somatic symptoms are notably high. These findings highlight the importance of weight management to minimize PMS symptoms. […] 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.

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

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

  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 A 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.

• #87 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 changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Changes in mRNA expression of serotonin receptors 5-HT1A and 5-HT2A, GABAARs, and central monoamine neurotransmitter receptors, including ER and ERb, progesterone receptors, and central steroidal hormone receptors, were seen in the limbic system of a macaque model with PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] 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.

• #88 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. […] 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.

• #89 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.

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

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

  Premenstrual syndrome (PMS) is a set of emotional and physical symptoms that typically occur up to 5 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when menstruation begins, or shortly thereafter. […] 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. Hormonal levels seem to be the same in women whether or not they have PMS. It is possible that women with PMS are somehow more sensitive to these changing levels of hormones. […] 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: […] 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.

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

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

  An 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. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

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

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

  The central nervous system (CNS) sensitivity hypothesis is another possibility. […] There are studies that indicate a hereditary component as well. […] Mood symptoms appear during the luteal phase and disappear immediately after menstruation, implying that gonadal steroids (estrogen and progesterone) have a role in PMS pathogenesis. […] One view is that predisposed women overreact to normal gonadal hormone changes and develop PMS symptoms as a result of neurochemical events. […] Induction of mood symptoms is caused by prolonged exposure to progesterone during the luteal phase and withdrawal from progesterone during menstruation. […] Estrogen receptors (ER and ER) and progesterone receptors (PR-A and PR-) have been found in cognition-related brain regions such as the amygdala, hippocampus (HIPP), and prefrontal cortex.

• #93 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. […] Current evidence suggests that PMS is a disorder triggered by changes in gonadal steroids during the LPMC in susceptible women. […] 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. […] The potential role of the GABAergic system in PMS has not been extensively investigated previously. […] 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.

• #94 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.

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

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

  An 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. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

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

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

  An 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. […] Chronic inflammation may represent the link between peripheral symptoms and central integrated responses to stressors with significant modulation by gonadal steroids.

• #97 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.

• #98 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 changing topology of the brain concerning pain is suggested to contribute to the understanding of the neurological mechanism of PMS. […] Changes in mRNA expression of serotonin receptors 5-HT1A and 5-HT2A, GABAARs, and central monoamine neurotransmitter receptors, including ER and ERb, progesterone receptors, and central steroidal hormone receptors, were seen in the limbic system of a macaque model with PMS. […] The involvement of the CNS in PMS is becoming clear due to an increase in brain imaging studies. […] 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.

• #99 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 etiology of PMS is associated with cognitive and psychosocial learning theories. […] Functions of the CNS, abnormal responses to normal hormonal changes, changes in GM volume in the brain, differences in activities in the resting state of the brain, abnormalities in the limbic system, causes of disturbances in emotion processing and regulation, genetic predispositions and their explanations, and the role of nutrition, mineral, and vitamin intake were presented to shed light on the mechanism. […] The pathophysiology of PMS has been reported to be highly complicated, involving many factors, including genetic, cultural, physiological, particularly brain physiology, and psychological explanations.

• #100 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.

• #101 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #102 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

  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.

• #103 Premenstrual Syndrome (PMS): 37 Symptoms, Definition, Treatment

  https://www.medicinenet.com/premenstrual_syndrome/article.htm

  The hallmark of the diagnosis of PMS is the symptom-free interval after the menstrual flow and before the next ovulation. […] The most helpful diagnostic tool is the menstrual diary, which documents physical and emotional symptoms over months. […] The treatment of PMS can sometimes be as challenging as making the diagnosis of PMS. Various treatment approaches have been used to treat this condition. […] It is important to know that these drugs, although useful in treating mood disturbances in some women, are not necessarily effective in treating the physical symptoms. […] Evidence suggests that exercise can help relieve some of the symptoms of PMS in adolescents and young women. […] Although there is no „cure” for PMS at this time, there are many options for managing its signs and symptoms.

• #104 Premenstrual Syndrome (PMS): 37 Symptoms, Definition, Treatment

  https://www.medicinenet.com/premenstrual_syndrome/article.htm

  The hallmark of the diagnosis of PMS is the symptom-free interval after the menstrual flow and before the next ovulation. […] The most helpful diagnostic tool is the menstrual diary, which documents physical and emotional symptoms over months. […] The treatment of PMS can sometimes be as challenging as making the diagnosis of PMS. Various treatment approaches have been used to treat this condition. […] It is important to know that these drugs, although useful in treating mood disturbances in some women, are not necessarily effective in treating the physical symptoms. […] Evidence suggests that exercise can help relieve some of the symptoms of PMS in adolescents and young women. […] Although there is no „cure” for PMS at this time, there are many options for managing its signs and symptoms.

• #105 Premenstrual Syndrome (PMS): 37 Symptoms, Definition, Treatment

  https://www.medicinenet.com/premenstrual_syndrome/article.htm

  The hallmark of the diagnosis of PMS is the symptom-free interval after the menstrual flow and before the next ovulation. […] The most helpful diagnostic tool is the menstrual diary, which documents physical and emotional symptoms over months. […] The treatment of PMS can sometimes be as challenging as making the diagnosis of PMS. Various treatment approaches have been used to treat this condition. […] It is important to know that these drugs, although useful in treating mood disturbances in some women, are not necessarily effective in treating the physical symptoms. […] Evidence suggests that exercise can help relieve some of the symptoms of PMS in adolescents and young women. […] Although there is no „cure” for PMS at this time, there are many options for managing its signs and symptoms.

• #106 Premenstrual Syndrome (PMS): Causes, Symptoms and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/premenstrual-syndrome

  PMS can start as early as within the first year after establishing menarche. Hormonal changes during a menstrual cycle and chemical changes in the brain can contribute to PMS. […] To confirm a diagnosis of PMS, a woman has at least one symptom that is physical or behavioral in at least three consecutive menses, and must impair functioning in some way in the days leading up to the menses and disappear once menses begins or shortly after the onset of menses.

• #107 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

  Difficulties remain in defining the condition, identifying its aetiology and in understanding why some women are sensitive to developing this cyclical condition, which is linked to the menstrual cycle and characterised by mainly affective symptoms such as irritability and dysphoria. […] The link to the menstrual cycle strongly implicates gonadal sex steroids in the genesis of symptoms, however, endocrinological studies have not revealed convincing abnormalities to date. […] A frequently cited study by Schmidt et al (1991) used a progesterone antagonist to manipulate PMS patients’ hormones such that some were fooled as to where they were in their cycle by artificially inducing menstruation early. […] This study suggests that hormonal events before the late luteal phase could set in motion interactions resulting in symptoms premenstrually and, from the psychological perspective, it also suggests that premenstrual symptoms cannot be explained solely by expectation bias.

• #108 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #109 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

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

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

  Magnesium and calcium deficiencies may contribute. […] In PMDD, symptoms occur regularly and only during the 2nd half of the menstrual cycle; symptoms end with menses or shortly after. […] PMDD is severely distressing, disabling, and often underdiagnosed. […] 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. […] SSRIs are the medications of choice for relief of anxiety, irritability, and other emotional symptoms, particularly if stress cannot be avoided. […] For some women, hormonal manipulation is effective. […] Rarely, for very severe or refractory symptoms, a gonadotropin-releasing hormone (GnRH) agonist (eg, leuprolide 3.75 mg IM, goserelin 3.6 mg subcutaneously every month) with low-dose estrogen/progestin is given to minimize cyclic fluctuations.

• #111 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. […] Premenstrual Dysphoric Disorder. Premenstrual dysphoric disorder (PMDD) follows the same pattern as PMS, but the symptoms are more disruptive. Women with PMDD may experience panic attacks, crying spells, suicidal thoughts, insomnia, or other problems than interfere with daily life. […] PMS Remedy: Hormone Treatments. Birth control pills prevent ovulation by regulating hormones. This usually leads to lighter periods and may reduce the symptoms of PMS. Other hormonal treatments may include GnRH agonists lupron or nafarelin, or synthetic steroids such as danazol. You may need to try more than one type before you find one that gives you relief.

• #112 Managing premenstrual syndrome (PMS) | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/

  These medicines cause a temporary and reversible menopause, so you will not release eggs and you will not have any periods. […] If you use GnRH analogues for more than 6 months, it may affect your bone strength (osteoporosis). You will be advised to take hormone replacement therapy (HRT) to protect your bones and reduce your menopausal symptoms, such as hot flushes. […] Using estrogen hormone patches or gel can improve the physical and psychological symptoms of PMS. […] Some women find using the combined oral contraceptive pill helps with PMS symptoms. Newer types of contraceptive pills containing a progestogen called drospirenone have been shown to improve PMS symptoms.

• #113 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #114 Managing premenstrual syndrome (PMS) | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/

  These medicines cause a temporary and reversible menopause, so you will not release eggs and you will not have any periods. […] If you use GnRH analogues for more than 6 months, it may affect your bone strength (osteoporosis). You will be advised to take hormone replacement therapy (HRT) to protect your bones and reduce your menopausal symptoms, such as hot flushes. […] Using estrogen hormone patches or gel can improve the physical and psychological symptoms of PMS. […] Some women find using the combined oral contraceptive pill helps with PMS symptoms. Newer types of contraceptive pills containing a progestogen called drospirenone have been shown to improve PMS symptoms.

• #115 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #116 Managing premenstrual syndrome (PMS) | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/

  These medicines cause a temporary and reversible menopause, so you will not release eggs and you will not have any periods. […] If you use GnRH analogues for more than 6 months, it may affect your bone strength (osteoporosis). You will be advised to take hormone replacement therapy (HRT) to protect your bones and reduce your menopausal symptoms, such as hot flushes. […] Using estrogen hormone patches or gel can improve the physical and psychological symptoms of PMS. […] Some women find using the combined oral contraceptive pill helps with PMS symptoms. Newer types of contraceptive pills containing a progestogen called drospirenone have been shown to improve PMS symptoms.

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

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

  Fluid retention may be relieved by reducing sodium intake and taking a diuretic just before symptoms are expected. […] In women with severe symptoms, bilateral oophorectomy may alleviate symptoms because it eliminates menstrual cycles; hormone replacement therapy is then indicated until about age 51 (the average for menopause).

• #118 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. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] 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.

• #119 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.

• #120 Premenstrual Syndrome (PMS) – HealthyWomen

  https://www.healthywomen.org/condition/premenstrual-syndrome-pms

  Overall, common treatment options include: Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications are used to relieve premenstrual headache and other menstrual-cycle related pain. […] Some women with PMS or PMDD experience relief of their symptoms after they start taking birth control pills. […] GnRH agonists (gonadotropin-releasing hormone). These medications include leuprolide (Lupron), among others. They belong to a class of hormones used to temporarily shrink fibroids and relieve endometriosis. […] Antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are the preferred antidepressants for treating severe PMS and PMDD symptoms, including depression. […] If a healthy diet, regular exercise and calcium supplements fail to improve mood swings or other emotional symptoms of PMS, you may want to talk to your health care professional about a serotonin reuptake inhibitor (SSRI) antidepressant medication. […] If you suffer from the physical and psychological symptoms typical in premenstrual syndrome (PMS), calcium may help solve your problem. In one study, women who took 600 mg of calcium twice a day experienced fewer PMS symptoms than women who took a placebo.

• #121 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. These changing hormone levels may affect some women more than others. […] Some studies have shown that certain vitamins may help with some symptoms of PMS. They include calcium and vitamin B6.

• #122 Premenstrual Syndrome (PMS): 37 Symptoms, Definition, Treatment

  https://www.medicinenet.com/premenstrual_syndrome/article.htm

  The hallmark of the diagnosis of PMS is the symptom-free interval after the menstrual flow and before the next ovulation. […] The most helpful diagnostic tool is the menstrual diary, which documents physical and emotional symptoms over months. […] The treatment of PMS can sometimes be as challenging as making the diagnosis of PMS. Various treatment approaches have been used to treat this condition. […] It is important to know that these drugs, although useful in treating mood disturbances in some women, are not necessarily effective in treating the physical symptoms. […] Evidence suggests that exercise can help relieve some of the symptoms of PMS in adolescents and young women. […] Although there is no „cure” for PMS at this time, there are many options for managing its signs and symptoms.

• #123 Premenstrual syndrome (PMS) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/premenstrual-syndrome-pms

  Its not clear why some people have PMS, but it may be associated with how certain chemicals in the brain interact with the hormone progesterone. […] Other factors can influence PMS. For example: physical and emotional mental health, stress levels, lifestyle.

• #124 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. […] Premenstrual Dysphoric Disorder. Premenstrual dysphoric disorder (PMDD) follows the same pattern as PMS, but the symptoms are more disruptive. Women with PMDD may experience panic attacks, crying spells, suicidal thoughts, insomnia, or other problems than interfere with daily life. […] PMS Remedy: Hormone Treatments. Birth control pills prevent ovulation by regulating hormones. This usually leads to lighter periods and may reduce the symptoms of PMS. Other hormonal treatments may include GnRH agonists lupron or nafarelin, or synthetic steroids such as danazol. You may need to try more than one type before you find one that gives you relief.

• #125 Treatment of premenstrual syndrome and premenstrual dysphoric disorder – UpToDate

  https://www.uptodate.com/contents/treatment-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder

  The epidemiology, pathogenesis, clinical manifestations, and diagnosis/differential diagnosis of PMS and PMDD are discussed separately. […] The core symptoms of premenstrual syndrome (PMS) include affective symptoms, such as depression, irritability, and anxiety, and somatic symptoms, such as breast pain, bloating and swelling, and headache. […] A clear diagnosis of PMS or PMDD should be established before treatment is considered. […] The treatment goals for patients with premenstrual disorders are to relieve symptoms and improve functional impairment.

• #126 Pathophysiology and Treatment of Premenstrual Syndrome | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-4684-5275-4_20

  Premenstrual Syndrome is a complex psychoneuroendocrine disorder that results in recurrent temporary disruption of the personal and professional lives of a substantial number of women throughout their reproductive years. […] Conflicting theories about the pathophysiology of PMS and a host of alleged but unproven remedies have both confused and frustrated practitioners faced with the reality of treating affected individuals. […] The dissatisfaction and skepticism that this has generated among physicians has, in general, resulted in a disinterest in PMS which is mirrored by the paucity of information on this subject in most texts on obstetrics and gynecology.

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