Premenstrual syndrome (PMS) is considered as a health problem that affects millions of women of reproductive age and, in some cases, may be severe enough to be considered a premenstrual dysphoric disorder (PMDD). Both PMS and PMDD are composed of affective, behavioral, and physical symptoms. Risk factors identified that predispose to PMS/PMDD are age between 25 and 35 years, a psychiatric history, a family history of PMDD, unhealthy living habits, and stressful life events. In addition, a comorbidity of PMDD with various psychiatric disorders such as major depression and anxiety disorders has been established. Although the etiology is unknown, it is considered that PMDD is of a multifactorial nature and is likely to develop because of the interactions among genes, biological variables (the neurotransmitters and gonadal hormones), and environmental influences. The first-line treatment for PMDD is pharmacological with selective serotonin reuptake inhibitors. From a medical point of view there is some evidence of the efficacy of nonpharmacological treatments such as relaxation, aerobic, and cognitive behavioral therapy, which are used mostly in mild cases.
The major criticisms made to the conceptualization of PMDD as a clinical syndrome focus on pathologizing women�s biology and its consequent medicalization, which perpetuated misconceptions related to menses. Medicine would be opened up to other fields such as anthropology, sociology, and gender studies with qualitative studies to look for context and meaning to women�s suffering. It has been suggested that it might be more appropriate to introduce the concept of premenstrual or perimenstrual experience instead of PMDD.
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