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Premenstrual syndrome: systematic diagnosis and individualized therapy
1Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
Abstract:
Premenstrual syndrome, or PMS, typically involves physical symptoms like bloating, headache, and breast tenderness, along with psychological and behavioral changes like irritability, depression, and fatigue. Other conditions can mimic PMS, so it's important to rule out look-alikes such as contraceptive side effects, dysmenorrhea, and substance abuse. Moderate exercise and a healthy diet may alleviate symptoms for some patients. Others may require symptom-specific measures, hormonal therapy, psychotropic drugs, or, for recalcitrant cases, ovulation suppression.
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At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.

