Premenstrual Syndrome and Premenstrual Dysphoric Disorder: Symptoms and Cluster Influences

Many women in their reproductive years experience some mood, behavioral, or physical symptoms in the week prior to menses. Women experiencing mild symptoms may have a wide variability in the level of symptom burden, whereas a minority suffers severe and debilitating symptoms. Severe premenstrual syndrome (PMS) affects 3% to 5% of women of reproductive age and has been classified under the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) as premenstrual dysphoric disorder (PMDD). Both disorders are characterized mainly by symptoms confined to the premenstrual period, which reduce not only patients' quality of life, but also their working activities. Women suffering PMDD experience severe dysphoric mood, and a greater desire and actual intake of certain foods, demonstrating impaired cognitive performance during the luteal phase. Several theories have been proposed to explain the underlying mechanisms of PMS and PMDD with complex bio-psycho-social factors involved. Although precise causes are unknown, the late luteal phase could be associated with diverse psychosomatic and behavioral symptoms appearing premenstrually which should be appropriately treated. Notwithstanding this high prevalence, no specific symptoms or signs appear, nor have any recognizable anatomical factors been identified in women suffering PMS or PMDD, and hence, no universal treatment yet exists. Despite this, therapeutic progress has been reached, although the ideal treatment has not yet been obtained due to the many clusters involved.