What Women Should Know About Premenstrual Syndrome

RRI.CO.ID.Jakarta : Every month, many women feel physical and emotional changes before their period starts. For most, it’s mild. But for about 1 in 10 women with premenstrual dysphoric disorder (PMDD), the symptoms are much more severe. Instead of normal discomfort, PMDD can cause intense depression, anxiety, anger, and even thoughts of hopelessness or suicide.

For a long time, doctors thought PMDD was caused only by abnormal hormone levels. Now, research shows it’s more complicated. Women with PMDD usually have normal levels of estrogen and progesterone. The problem is how their brains react to the normal ups and downs of these hormones during the menstrual cycle. A substance called allopregnanolone, made from progesterone, seems to play a key role by affecting the brain’s calming system in the opposite way for people with PMDD.

Scientists have also found differences in brain activity. People with PMDD often show higher activity in the amygdala, the part of the brain linked to fear and emotion, and less control from the prefrontal cortex, which helps manage feelings. Genetics, sleep problems, and changes in brain chemicals like serotonin and GABA may also make some people more likely to develop PMDD. Some studies even suggest that low melatonin and poor sleep can make symptoms worse.

PMDD follows a clear pattern. Symptoms usually start after ovulation and get better soon after menstruation begins. To diagnose it, doctors ask patients to track their symptoms for at least two cycles, because memory alone isn’t reliable. Unlike regular PMS, PMDD is severe enough to interfere with work, relationships, and daily life. It can cause irritability, rage, anxiety, and physical symptoms like headaches and sleep trouble.

Some patients notice their symptoms get worse at certain times of the year, especially in spring. Seasonal changes in light and sleep patterns might play a role, but researchers say there isn’t enough evidence yet to call it a proven cause. Still, the link between sleep, light, and mood is an area scientists are studying more closely.

Understanding these causes is changing how PMDD is treated. Instead of just treating symptoms, new drugs aim to stop the problem at its source. Some medications block progesterone signaling or counteract allopregnanolone to prevent mood changes. Other treatments include timed light exposure, low-dose melatonin, and traditional options like SSRIs, which can improve PMDD symptoms faster than they work for depression.

This progress gives real hope to people with PMDD. For decades, women’s mental health in this area was overlooked. Now, with new research on hormones, brain chemistry, and genetics, doctors have more targeted options. As one expert said, it’s a promising time because hormone-based therapies for women are finally becoming a reality after years of study.

Source; National Geographic health