(97) Premenstrual Dysphoric Disorder: Why are some girls more affected than others?

Background: This summary sets a deeper insight into premenstrual disorders in young girls and adolescents. Premenstrual Syndrome refers to a number of symptoms that start in the luteal phase and remit with menses, including emotional instability, depression, bloating, breast tenderness, fatigue or headache. According to the American College of Obstetricians and Gynecologists, symptoms emerge within five days before menstruation and resolute within four days, for at least three consecutive cycles. Premenstrual Dysphoric Disorder is a serious form of PMS, classified into depression disorders.

Methods: This abstract is a review, performed using PubMed and Google Scholar. Results were limited to reviews published between 2015 and 2024. Key words included “Premenstrual Syndrome”, “Premenstrual Dysphoric Disorder”, “adolescence”, “pathophysiology”.

Results: PMS affects 30% of young girls, while PMDD about 3-8%. It is associated with childhood trauma, stress ,migraine, while it may worsen other disorders such as ADHD or PTSD. The pathophysiology is a combination of genetic, hormonal and environmental factors. Some theories claim that fluctuation of estrogen and progesterone in the luteal phase may set off the symptoms.. Puberty timing is also important as early or late menarche puts adolescents in different risk. Estrogen decrease in the luteal phase leads to deregulation of serotonin, indicating the effectiveness of selective serotonin reuptake inhibitors (SSRIs) as treatment. Changes in lifestyle including exercise on a regular basis, a healthy diet and dietary supplements such as magnesium and vitamin D as well as combined oral contraceptives with both a progesterone derivative and ethinyl estradiol are an efficient treatment. Other treatments include GnRH agonists and non-contraceptive estradiol.

Conclusions: PMS is a complicated disorder that affects a significant rate of young girls, with an impact on their quality of life, leading to decreased productivity, missing days from school and daily activities. As a newly recognized syndrome, most adolescents are unaware and appropriate information is of crucial importance.