The pathophysiologic background for current treatments of premenstrual syndromes.
Multiple hypotheses on the etiology of premenstrual syndromes (PMS) that have been proposed during the past 70 years have led to a multitude of treatment modalities. During the past two decades, the following two classes of pharmacologic interventions have emerged: hormonal interventions--mostly suppression of ovulation; and neurotransmitter's activity stimulation--mostly by specific serotonin reuptake inhibitors. These treatment modalities are based on the hypothesis that the etiology and pathophysiology of PMS are related to ovulation-related luteal activity of gonadal hormones, and their interaction with serotonin and other neurotransmitters. Two other components of the pathophysiology of PMS--the genetic propensity and the dynamically evolving-vulnerability--have not yet been addressed for treatment. Environmental inputs to pathophysiology, which are not discussed here, have been addressed by attempts at changes of lifestyle, coping style, and environment.
Halbreich
Uriel
U
BioBehavioral Program, State University of New York (SUNY) at Buffalo, Clinical Center, 462 Grider Street, Buffalo, NY 14215, USA. urielh@acsu.buffalo.edu
D000328:Adult; D003613:Danazol / Q000494:pharmacology / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D010060:Ovulation / Q000187:drug effects; D011293:Premenstrual Syndrome / Q000188:drug therapy* / Q000503:physiopathology*; D018079:Receptors, GABA / Q000502:physiology; D011985:Receptors, Serotonin / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D003613:Danazol; D004965:Estrogen Antagonists; D018079:Receptors, GABA; D011985:Receptors, Serotonin; D017367:Selective Serotonin Reuptake Inhibitors