Aetiology of premenstrual syndrome

Aetiology

The cause is uncertain. Biological, genetic, psychological, environmental and social factors are thought to play an important role in the onset of symptoms (1,2).

• cyclical ovarian activity has been shown to have a significant effect since pre menstrual syndrome (PMS) before puberty, in pregnancy and after the menopause is not seen (2)
  
  
• a positive family history has been reported
  • around 70% of women with PMS symptoms had mothers who were affected when compared with 37% in women whose mothers have not been affected
  • 93% concordance rate in monozygotic twins when compared to 44 % in dizygotic twins (2)

It may become evident following childbirth or a disturbing life event.
An increased risk has been reported in

• women who are obese, perform less exercise and are of lower academic achievements (3)
• past, present or current domestic violence
• younger women, black women
  • black women tend to have a higher prevalence of food cravings than white women while white women are more likely than black women to report premenstrual mood changes and weight gain
• women with longer menstrual periods (2)

Lower incidence is seen in hormonal contraceptive users (1)

Reference:

1. The National Association for Premenstrual Syndrome (NAPS). Guidelines on Premenstrual Syndrome
2. Khajehei M. Aetiology, Diagnosis and Management of Premenstrual Syndrome. J Pain Relief. 2015:4: 193
3. Management of Premenstrual Syndrome: Green-top Guideline No. 48. BJOG. 2017;124(3):e73-e105.