--- title: What causes PMS and PMDD and what new treatments are being studied? description: PMS and PMDD involve changes in hormone sensitivity, serotonin levels, genetic factors, and inflammation. New treatments under research target progesterone re url: https://niyora.com/research/papers/recent-advances-in-understanding-management-of-premenstrual-dysphoric-disorder-2022/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - What causes PMS and PMDD and what new treatments are being studied? Survey study, 2022 # What causes PMS and PMDD and what new treatments are being studied? PMS and PMDD involve changes in hormone sensitivity, serotonin levels, genetic factors, and inflammation. New treatments under research target progesterone receptors and inflammatory pathways. Strong study design Review of research on women with PMS and PMDD ## What they did This is a review article that summarized recent research on the causes and new management approaches for PMS and PMDD published in medical journals. ## What they found Key factors include altered sensitivity to allopregnanolone, a metabolite of progesterone, reduced serotonin, genetic and epigenetic changes, and inflammatory molecules. New therapeutic approaches being studied include ulipristal acetate, dutasteride, and sepranolone. ## What it means for you Understanding of PMS and PMDD is complex and involves multiple body systems and inflammation. Promising new drugs are in research but need more testing before use. The connection between inflammation and brain chemistry may open new treatment paths. ## About the study Original title Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome Authors Tiranini L, Nappi RE Journal Faculty reviews Year 2022 Study design Survey study What was tested Review of investigational treatments Open access Yes Read the paper [doi.org/10.12703/r/11-11](https://doi.org/10.12703/r/11-11) Original abstract Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common disorders of the luteal phase of the menstrual cycle and are characterized by moderate to severe physical, affective, or behavioral symptoms that impair daily activities and quality of life. PMS and PMDD have recently raised great interest in the research community for their considerable global prevalence. The etiology of PMS/PMDD is complex. Ovarian reproductive steroids (estradiol and progesterone) are considered pathogenetic effectors, but the key feature seems to be an altered sensitivity of the GABAergic central inhibitory system to allopregnanolone, a neurosteroid derived from progesterone produced after ovulation. Also, a reduced availability of serotonin seems to be involved. New insights point to a role for genetic and epigenetic modifications of hormonal and neurotransmitter pathways, and inflammation is the potential link between peripheral and neurological integrated responses to stressors. Thus, new therapeutic approaches to PMS/PMDD include inhibition of progesterone receptors in the brain (i.e., with ulipristal acetate), reduced conversion of progesterone to its metabolite allopregnanolone with dutasteride, and possible modulation of the action of allopregnanolone on the brain GABAergic system with sepranolone. Further research is needed to better understand the interaction between peripheral inflammatory molecules (cytokines, interleukins, C-reactive protein, and reactive oxygen species) and the brain neurotransmitter systems in women with PMS/PMDD. If confirmed, neuroinflammation could lead both to develop targeted anti-inflammatory therapies and to define prevention strategies for the associated chronic inflammatory risk in PMS/PMDD. Finally, the observed association between premenstrual disorders and psychological diseases may guide prompt and adequate interventions to achieve a better quality of life. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/)[Neurosteroids (allopregnanolone)](https://niyora.com/research/topics/treatment-neurosteroids/)[Pregnancy and postpartum](https://niyora.com/research/topics/comorbidity-postpartum/)[Quality of life and daily functioning](https://niyora.com/research/topics/life-area-quality-of-life/) 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 Survey study, 2023 Could treatments that affect the brain's GABA system help PMDD? Randomised trial, 2017 Does Sepranolone reduce symptoms of severe premenstrual syndrome (PMDD)? Study, 2022 Why do women get PMS and PMDD? Systematic review, 2026 Why do some women experience mood changes linked to their menstrual cycle? Study, 2026 What treatments work for PMDD? Randomised trial, 2024 Does sertraline change brain chemicals in people with PMDD, and does this relate to symptom improvement? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗