The pathophysiology of premenstrual syndrome is complex, and imprecise
It is anticipated that PMS is likely to be influenced by the action of progesterone on neurotransmitters like gamma-aminobutyric acid (GABA), opioids, serotonin, and catecholamine. Pre existing serotonin deficiency with increased progesterone sensitivity is also considered responsible for this disorder.
An increase in prolactin levels or an increase in its sensitivity to the effect of prolactin, glucose metabolism alter ations, abnormal hypothalamic–pituitary–adrenal (HPA) axis function, insulin resistance, and certain nutritional electrolyte deficiencies, and genetic factors have a role in PMS
Stress amplifies the sympathetic activity, and this results in menstrual pain by significantly increasing the intensity of uterine contraction.
Women with PMS should keep a symptom diary for at least 2 cycles before starting treatment to exclude other conditions like psychiatric disorders (depression, anxiety, and panic disorders) and gynecological conditions like endometriosis and hypothyroidism, and the confirm the Diagnosis.
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