Disturbo disforico della fase luteale e sindrome premestruale

Background: Premenstrual Syndrome (PMS) comprises a wide variety of cyclical and recurrent symptoms, including physical, emotional, behavioral and cognitive symptoms that occur during the luteal phase of the menstrual cycle and rapidly resolve with the onset of menstrual bleeding. The tack of a clear diagnostic framework has brought to different epidemiological, etiopathogenetic and clinical conclusions over the years. Premenstrual Dysphoric Disorder (PMDD) is the most severe and disabling form of premenstrual disorder and occurs in 3-8% of cases, including always at least a dysphoric symptom. In some cases, it represents the premenstrual exacerbation of depression/anxiety symptomatology. Discussion and conclusions: PMS/PMDD represent a model of the cyclical psychoneuroendocrine compromise deriving from women's adaptive responses which fluctuate monthly in response to periodic sexual hormone variations throughout the menstrual cycle. The complexity of the syndrome is likely to be related to the peculiar threshold of vulnerability of each woman which is modulated during the reproductive life span by several biological and even psychosocial factors. That being so, symptoms are extremely diverse, no biochemical markers are evident and therapeutic management is not always easy. Estro-progestin preparations for hormonal contraception may represent a suitable reatment strategy.