Premenstrual Syndrome and Premenstrual Dysphoric Disorder as Centrally Based Disorders

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) encompass a variety of symptoms that occur during the luteal phase menstrual cycle impair daily life activities relationships. Depending on type severity physical, emotional or behavioral symptoms, women reproductive age followed for at least two prospective cycles may receive one diagnoses. PMDD is most severe form PMS, predominantly characterized by not due to another psychiatric disorder. PMS are common neuro-hormonal gynecological disorders with multifaceted etiology. Gonadal steroid hormones their metabolites influence plethora biological systems involved in occurrence specific but there no doubt PMS/PMDD centrally based disorders. A more sensitive neuroendocrine threshold cyclical variations estrogens progesterone under physiological hormonal therapies present. Moreover, altered brain sensitivity allopregnanolone, metabolite produced after ovulation potentiating GABA activity, along an impairment opioid serotoninergic systems, justify symptoms. Even neuro-inflammation expressed via GABAergic system investigation as etiological factor PMS/PMDD. Pharmacological management aims stabilize fluctuations restore balance. The rationale suppressing supports prescription combined contraception (CHC). Its effect mood highly variable depends biochemical characteristics exogenous steroids Hormonal regimens reducing estrogen-free interval menstruation seem better choices. Psychoactive agents, such serotonin reuptake inhibitors (SSRIs), effective be prescribed continuously only phase. Novel therapeutic approaches include inhibition receptors brain, i.e., ulipristal acetate, reduced conversion dutasteride, modulation action allopregnanolone sepranolone.