Premenstrual Syndromes : PMS and PMDD - Rutuja :: The site ...

In conclusion, it appears that the genesis of the symptoms
of PMS may entail alterations of the serotogenic,
GABA, and the endorphin systems. There is a growing
body of evidence for the interaction of these networks
in production of severe premenstrual symptoms. SSRIs,
the current treatment of choice for PMDD, increase the
activity of the enzymes required for the formation of
allopregnanolone and, as a result, brain and CSF allopregnanolone
concentrations. 41,152,153 Another serotonergic
compound, L-tryptophan was also shown to
increase peripheral allopregnanolone in women with
PMS. 154 Reduced luteal phase GABAergic sensitivity in
women with PMS was normalized after the administration
of an SSRI. 54
The connection between the GABA A receptor system,
serotonin, and EOPs was recently highlighted by an
investigation of LH response to an estrogen challenge,
suggesting increased GnRH activity in women with
PMS. 155 After estrogen exposure, GnRH is restrained
tonically by GABA and by endogenous opioid peptides
41 and serotonin modulates the GABA A receptor
complex. 155,156 Clearly, the fluctuation of sex steroids
across the menstrual cycle profoundly affects all three
candidate systems and it is likely that genetically programmed
and environmentally driven differences are
responsible for the defining features of each individual’s
affective, behavioral, and physical premenstrual
state.
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