23 April 2024 | Stefan Modzelewski*, Aleksandra Oracz, Xawery Żukow, Kamila Iłendo, Zofia Śledzikowka and Napoleon Waszkiewicz
Premenstrual syndrome (PMS) is a common disorder affecting women of reproductive age, with a global prevalence of 47.8%, and severe symptoms occurring in 3-8% of cases. The disorder is characterized by physical and psychological symptoms, including irritability, tearfulness, anxiety, depressed mood, abdominal bloating, breast tenderness, and headaches. Hormonal changes, stress, diet, and alterations in neurotransmission are significant risk factors. Recent studies have focused on the role of GABA conductance and neurosteroid levels, particularly allopregnanolone, in the etiology of PMS. Allopregnanolone, a progesterone metabolite, is an allosteric modulator of the GABA receptor and plays a crucial role in the disorder's pathogenesis. The treatment of PMS aims to alleviate symptoms and improve quality of life. Pharmacological interventions, such as SSRIs, hormonal agents, and neurosteroids, are used to manage PMS. Non-pharmacological methods, including lifestyle changes and cognitive-behavioral therapy, are also considered. The choice of treatment regimen should be individualized based on the patient's clinical situation. Oral contraceptives containing drospirenone and ethinylestradiol are the most effective for controlling symptoms, while SSRIs are the first-line treatment for severe PMS due to their rapid and effective effects. However, the exact mechanisms and optimal dosages of these treatments require further research.Premenstrual syndrome (PMS) is a common disorder affecting women of reproductive age, with a global prevalence of 47.8%, and severe symptoms occurring in 3-8% of cases. The disorder is characterized by physical and psychological symptoms, including irritability, tearfulness, anxiety, depressed mood, abdominal bloating, breast tenderness, and headaches. Hormonal changes, stress, diet, and alterations in neurotransmission are significant risk factors. Recent studies have focused on the role of GABA conductance and neurosteroid levels, particularly allopregnanolone, in the etiology of PMS. Allopregnanolone, a progesterone metabolite, is an allosteric modulator of the GABA receptor and plays a crucial role in the disorder's pathogenesis. The treatment of PMS aims to alleviate symptoms and improve quality of life. Pharmacological interventions, such as SSRIs, hormonal agents, and neurosteroids, are used to manage PMS. Non-pharmacological methods, including lifestyle changes and cognitive-behavioral therapy, are also considered. The choice of treatment regimen should be individualized based on the patient's clinical situation. Oral contraceptives containing drospirenone and ethinylestradiol are the most effective for controlling symptoms, while SSRIs are the first-line treatment for severe PMS due to their rapid and effective effects. However, the exact mechanisms and optimal dosages of these treatments require further research.