Premenstrual syndrome (PMS) is a common disorder affecting women of reproductive age, with an estimated global prevalence of 47.8%, and severe symptoms occurring in 3-8%, significantly affecting daily functioning. GABA conductance and changes in neurosteroid levels, particularly allopregnanolone, are suspected to play a substantial role in the disorder's etiology. This paper provides an overview of recent reports on the etiology and recognized therapeutic approaches, encompassing both pharmacological and non-pharmacological interventions. The treatment of PMS is crucial for enhancing the quality of life for affected women. Medications used in PMS treatment should be individually selected to achieve the best therapeutic effect, considering the clinical situation of the patients. PMS is associated with hormonal changes, stress, diet, and alterations in neurotransmission. The most common mental symptoms of PMS include irritability, tearfulness, anxiety, and depressed mood. Physical symptoms mainly involve abdominal bloating, breast tenderness, and headaches. The etiopathogenesis of PMS is intricate and not fully understood. Several theories attempt to explain the causes of its symptoms. Classically, PMS has been linked to hormonal fluctuations during the monthly cycle, with mood deterioration and increased anxiety primarily associated with decreases in estrogen and progesterone. Recent studies have focused on the role of sex steroids and their derivatives, particularly allopregnanolone, which is an allosteric modulator of the GABA receptor in the CNS. Allopregnanolone synthesis can occur de novo in the brain, ovaries, and adrenal glands. Understanding the significance of allopregnanolone in alleviating PMS symptoms may provide crucial information about the cause of the disorder itself. Allopregnanolone has become one of the most commonly linked substances to the etiology of PMS in recent years. SSRIs are used in the treatment of PMS and have been shown to stimulate the formation of BDNF, a growth factor. Recent studies have shown that during the monthly cycle in women suffering from PMDD, there is an increase in serotonin uptake during the premenstrual period. Additionally, increased serotonin transporter correlated with increased depressive symptoms. This indicates that the key may be the change in extracellular serotonin levels itself. The mechanism of action of SSRIs in managing PMS/PMDD is complex, encompassing the modulation of GABA via neuroactive steroids. The SSRI's impact on neuroactive steroid levels involves processes such as the redirection of biosynthetic pathways from progesterone towards neuroactive metabolites. Additionally, substrates are directed towards enhancing GABA_A function positively, while competitive inhibition of enzyme substrates also plays a role. These mechanisms may contribute to the modulation of neuroactive steroid levels, suggesting the impact of SSRIs in addressing PMS/PMDD symptoms. Hormone treatment aims to eliminate fluctuations in sex hormones during the menstrual cycle.Premenstrual syndrome (PMS) is a common disorder affecting women of reproductive age, with an estimated global prevalence of 47.8%, and severe symptoms occurring in 3-8%, significantly affecting daily functioning. GABA conductance and changes in neurosteroid levels, particularly allopregnanolone, are suspected to play a substantial role in the disorder's etiology. This paper provides an overview of recent reports on the etiology and recognized therapeutic approaches, encompassing both pharmacological and non-pharmacological interventions. The treatment of PMS is crucial for enhancing the quality of life for affected women. Medications used in PMS treatment should be individually selected to achieve the best therapeutic effect, considering the clinical situation of the patients. PMS is associated with hormonal changes, stress, diet, and alterations in neurotransmission. The most common mental symptoms of PMS include irritability, tearfulness, anxiety, and depressed mood. Physical symptoms mainly involve abdominal bloating, breast tenderness, and headaches. The etiopathogenesis of PMS is intricate and not fully understood. Several theories attempt to explain the causes of its symptoms. Classically, PMS has been linked to hormonal fluctuations during the monthly cycle, with mood deterioration and increased anxiety primarily associated with decreases in estrogen and progesterone. Recent studies have focused on the role of sex steroids and their derivatives, particularly allopregnanolone, which is an allosteric modulator of the GABA receptor in the CNS. Allopregnanolone synthesis can occur de novo in the brain, ovaries, and adrenal glands. Understanding the significance of allopregnanolone in alleviating PMS symptoms may provide crucial information about the cause of the disorder itself. Allopregnanolone has become one of the most commonly linked substances to the etiology of PMS in recent years. SSRIs are used in the treatment of PMS and have been shown to stimulate the formation of BDNF, a growth factor. Recent studies have shown that during the monthly cycle in women suffering from PMDD, there is an increase in serotonin uptake during the premenstrual period. Additionally, increased serotonin transporter correlated with increased depressive symptoms. This indicates that the key may be the change in extracellular serotonin levels itself. The mechanism of action of SSRIs in managing PMS/PMDD is complex, encompassing the modulation of GABA via neuroactive steroids. The SSRI's impact on neuroactive steroid levels involves processes such as the redirection of biosynthetic pathways from progesterone towards neuroactive metabolites. Additionally, substrates are directed towards enhancing GABA_A function positively, while competitive inhibition of enzyme substrates also plays a role. These mechanisms may contribute to the modulation of neuroactive steroid levels, suggesting the impact of SSRIs in addressing PMS/PMDD symptoms. Hormone treatment aims to eliminate fluctuations in sex hormones during the menstrual cycle.