---
title: What causes PMS and PMDD? | Niyora
description: PMS and PMDD are triggered by hormonal changes after ovulation, but not by abnormal hormone levels. The brain's calming system (GABA) and mood system (seroton
url: https://niyora.com/research/papers/pathophysiology-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder-2012/
---

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- What causes PMS and PMDD?

Review, 2012

# What causes PMS and PMDD?

PMS and PMDD are triggered by hormonal changes after ovulation, but not by abnormal hormone levels. The brain's calming system (GABA) and mood system (serotonin) are both affected by progesterone changes.

 Early or limited evidence

Scientific literature review

## What they did

Researchers reviewed scientific literature on the causes and mechanisms of PMS and PMDD, focusing on hormones, neurotransmitters, and brain systems.

## What they found

Symptoms start in the luteal phase after ovulation but are not related to specific hormone concentrations. Progesterone metabolites reduce GABA system function in the brain. Low serotonin produces PMS-like symptoms. Medicines that increase serotonin help PMS symptoms, even when used only during the luteal phase. The underlying cause likely involves complex brain circuitry rather than problems with single neurotransmitters.

## What it means for you

PMS and PMDD result from the brain's sensitivity to normal hormonal changes, not from abnormal hormones. This explains why hormone levels are typically normal in women with these conditions. However, much remains unknown about exactly how these brain systems cause symptoms.

2

main brain systems: GABA and serotonin

## About the study

Original title Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder Authors Rapkin AJ, Akopians AL Journal Menopause international Year 2012 Study design Review What was tested none Read the paper [doi.org/10.1258/mi.2012.012014](https://doi.org/10.1258/mi.2012.012014)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/)[Neurosteroids (allopregnanolone)](https://niyora.com/research/topics/treatment-neurosteroids/)[Calcium](https://niyora.com/research/topics/treatment-calcium/)[Surgical menopause](https://niyora.com/research/topics/treatment-surgery/)

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

## Related studies

Randomised trial, 2003

What treatments work for PMS and PMDD?

Case report, 2023

Can stopping ovulation help severe PMDD when other treatments do not work?

Study, 2008

How common is PMDD and how does it affect women's lives?

Review, 2018

What are the most effective treatments for premenstrual syndrome and PMDD?

Review, 2017

What causes PMDD and what are the best treatments?

Survey study, 2026

What are the causes, diagnosis, and treatments for PMS and PMDD?

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