aetiology of premenstrual syndrome

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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)


Last edited 09/2018