Premenstrual syndrome. Advances in diagnosis and treatment.

Premenstrual syndrome and PMDD are increasingly recognized as medical entities that adversely affect the quality of life of a subset of women. When research criteria or the strict definition of PMDD are used, the prevalence of PMS is thought to range from 3% to 5% among reproductive-aged women. Although the precise pathophysiology is not known, it is increasingly believed that women with PMS have an altered sensitivity of central neurotransmitters, particularly serotoninergic, to normal circulating levels of estradiol and progesterone. Significant advances have been made in pharmacologic therapy for PMDD, with the largest clinical trials demonstrating efficacy of the SSRIs. These studies show relief of distressing mood symptoms and improvements in parameters of social function in most patients.