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Review, 2012

What causes PMS and PMDD?

PMS and PMDD are triggered by hormonal changes after ovulation, but not by abnormal hormone levels. The brain's calming system (GABA) and mood system (serotonin) are both affected by progesterone changes.

Early or limited evidence Scientific literature review

What they did

Researchers reviewed scientific literature on the causes and mechanisms of PMS and PMDD, focusing on hormones, neurotransmitters, and brain systems.

What they found

Symptoms start in the luteal phase after ovulation but are not related to specific hormone concentrations. Progesterone metabolites reduce GABA system function in the brain. Low serotonin produces PMS-like symptoms. Medicines that increase serotonin help PMS symptoms, even when used only during the luteal phase. The underlying cause likely involves complex brain circuitry rather than problems with single neurotransmitters.

What it means for you

PMS and PMDD result from the brain's sensitivity to normal hormonal changes, not from abnormal hormones. This explains why hormone levels are typically normal in women with these conditions. However, much remains unknown about exactly how these brain systems cause symptoms.

2

main brain systems: GABA and serotonin

About the study

Original title
Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder
Authors
Rapkin AJ, Akopians AL
Journal
Menopause international
Year
2012
Study design
Review
What was tested
none

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