The premenstrual syndrome

Several areas of premenstrual syndrome (PMS) research have seen significant recent progress. The diagnosis of the syndrome may become more uniform and practical if the Calendar of Premenstrual Experiences achieves widespread acceptance. The roles for sex steroids in the origin and treatment of the disease have become more problematic. A large, well-designed study has found that progesterone supplementation is no better than placebo therapy. Elimination of menstrual cyclicity by surgical or medical means effectively treats PMS; replacement of sex steroids does not seem to make PMS symptoms recur, and may become a successful, long-term treatment. The pathophysiology of PMS remains unexplained, but may involve recent findings regarding PMS and sex steroids, nutritional factors, and the adrenal axis.