Some clues to the etiology of premenstrual syndrome/premenstrual dysphoric disorder

Menstrually related disorders affect a significant number of women of reproductive age. The pathobiology of menstrually related disorders, specifically premenstrual syndromes, involve multifaceted interactions between processes of the central nervous system, hormones, and other modulators. These interactions include gonadal hormones, their metabolites, and several neurotransmitters and neurohormonal systems, including serotonin, γ-aminobutyric acid, and rennin-angiotensin-aldosterone system. In vulnerable women, response of these systems to normal fluctuations of gonadal hormones may contribute to expressions of symptoms. Disrupted homeostasis and impaired adaptation may be an important underlying mechanism.