Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Syndrome (PMS) are terms used to describe the physical, mental and emotional symptoms that occur in some women a few days before menstruation and disappear when it starts. These sometimes intense emotional and physical symptoms, such as irritability, anxiety and depression, can include body aches, difficulty concentrating, mood swings and other unpleasant sensations.
Recent research into premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) has revealed that they are widespread and have complex origins.
In simple terms, they are due to imbalances in female hormones such as estradiol and progesterone.
These hormones are involved in regulating mood and well-being.
Another key player in the development of PMS/PMDD is a compound called allopregnanolone, which is derived from progesterone.
This compound affects the nervous system, in particular the GABAergic inhibitory system, which regulates arousal in the brain.
Research suggests that in some women, this system does not function properly during the premenstrual phase, which may contribute to the emotional symptoms of PMS/PMDD.
In addition, a decrease in serotonin, a neurotransmitter associated with well-being and mood regulation, also appears to play a role in the development of these disorders.
Furthermore, recent advances suggest that changes in the way genes are switched on or off (epigenetics) may also contribute to susceptibility to PMS/PMDD.
Finally, inflammation, the body's response to stress and aggression, could play an important role in linking peripheral and neurological responses in the development of these disorders.
As far as treatment is concerned, certain drugs such as selective serotonin reuptake inhibitors (SSRIs) and oral contraceptives can help alleviate symptoms. For more severe cases, hormone-regulating drugs or even surgery may be considered.
There are also options such as acupuncture, self-hypnosis, meditation, yoga and dietary changes that may help some women manage their symptoms, although the research on these approaches is less clear.
In summary, PMS/PMDD are complex conditions resulting from multiple factors, including hormonal imbalances, alterations in the nervous system and genetic and inflammatory factors, but there are different ways to treat its symptoms and improve the quality of life of women who suffer from it.
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Sources:
Management of Premenstrual Dysphoric Disorder: A Scoping Review.
Carlini SV, Lanza di Scalea T, McNally ST, Lester J, Deligiannidis KM.
Int J Womens Health. 2022 Dec 21;14:1783-1801. doi: 10.2147/IJWH.S297062.
Tiranini L, Nappi RE.
Fac Rev. 2022 Apr 28;11:11. doi: 10.12703/r/11-11. eCollection 2022.