[Premenstrual syndrome and dysphoric premenstrual syndrome]

Premenstrual syndrome is characterized by physical, cognitive, affective and behavioral symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolved quickly at the beginning or within few days after menstruation started. The most severe form is represented by premenstrual dysphoric disorder included in the DSM 5. Over 40% of women experience emotional symptoms such as irritability, tension, emotional lability; and physical symptoms such as breast tenderness, fatigue, and abdominal distension. It has not yet been established the underlying pathophysiological mechanism, although hypotheses related to sex hormones and the GABAergic and serotonergic regulation have been postulated. Treatment includes nonpharmacologic and pharmacologic interventions, being serotonin reuptake inhibitors the first-line treatment.