Managing Premenstrual Symptoms - Association of Reproductive ...

Etiology of Premenstrual Disorders 14,15
Although the etiology of premenstrual disorders is unclear, hypotheses
abound and include the following:
• Allergies
• Catecholamine alterations
• Endorphin withdrawal
• Fluid retention
• Hormonal alterations (high estrogen, falling estrogen,
changes in estrogen-progesterone ratio, excess prolactin)
• Hypoglycemia
• Increased adrenal activity
• Increased aldosterone activity
• Increased renin-angiotensin activity
• Nutritional deficiencies
• Prostaglandin impact
• Psychological or psychogenic effects
Additionally, there may be a concomitant overlay of other disorders
such as stress, posttraumatic stress, anxiety disorder, and depression.
References
4
1. Yonkers KA, Pearlstein T, Rosenheck RA. Premenstrual disorders: bridging
research and clinical reality. Arch Womens Ment Health. 2003;6(4):287–92.
2. Moline ML, Zendell SM. Evaluating and managing premenstrual syndrome.
Medscape Womens Health 2000;5(2):1. Available at www.medscape.com/
viewarticle/408913. Accessed March 25, 2008.
3. Steiner M. Premenstrual syndrome and premenstrual dysphoric disorder:
guidelines for management. J Psychiatry Neurosci. 2000;25(5):459–68.
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders, 4th ed., Text Revision. Washington, DC: American Psychiatric
Association, 2000.
5. Mishell DR Jr. Premenstrual disorders: epidemiology and disease burden. Am J
Manag Care. 2005;11(16 Suppl):S473–9.
6. Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment,
impact, and burden of premenstrual dysphoric disorder (PMS/PMDD).
Psychoneuroendocrinology. 2003;28(Suppl 3):1–23.
Managing Premenstrual Symptoms June 2008