Premenstrual syndrome and cortisol
Premenstrual syndrome (PMS), including the severe subtype premenstrual dysphoric disorder (PMDD), DSM-5 category, represents a challenging combination of hormonal, environmental and neuroendocrine dysfunctions with menstrual cycle-related pattern. Controversies around the role of daily stress and as...
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2021-03-01
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| Series: | Romanian Journal of Medical Practice |
| Subjects: | |
| Online Access: | https://rjmp.com.ro/articles/2021.1/RJMP_2021_1_Art-02.pdf |
| _version_ | 1818728541407150080 |
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| author | Florica SANDRU Mihai Cristian DUMITRASCU Eugenia PETROVA Adina GHEMIGIAN Nicoleta DUMITRU Mara CARSOTE Ana VALEA |
| author_facet | Florica SANDRU Mihai Cristian DUMITRASCU Eugenia PETROVA Adina GHEMIGIAN Nicoleta DUMITRU Mara CARSOTE Ana VALEA |
| author_sort | Florica SANDRU |
| collection | DOAJ |
| description | Premenstrual syndrome (PMS), including the severe subtype premenstrual dysphoric disorder (PMDD), DSM-5 category, represents a challenging combination of hormonal, environmental and neuroendocrine dysfunctions with menstrual cycle-related pattern. Controversies around the role of daily stress and associated anomalies of hypothalamic-pituitary-adrenal axis are related to the fact that stress is all the time, not just a fluctuating element. This is a narrative review on PMS/PMDD and cortisol profile. 46 articles are cited (between 2009 and 2020). PMD/PMDD underlines multiple imbalances and anomalies of the cortisol levels or its secretory pattern may be a few of them, despite the fact that multiple controversies are still present and most of studies are of limited statistical power. Women with PMS may have higher levels of cortisol in relationship to stress independently of the cycle phase, also a delay of CAR (cortisol awakening response) peak and a delayed cortisol slope during day time. It does not seem that CAR pattern is related to the phases of menstrual cycle. CAR anomalies may be associated with pain perception disturbances in PMS females. The most modern area of interest is related to allopregnanolone, a progesterone metabolite with neuroactive profile. The diurnal serum baseline cortisol and the values of cortisol after dexamethasone suppression test may be similar between patients with PMS and without, but the females with PMS that have higher allopregnanolone associate blunted values of cortisol during the night versus control (without PMS) and versus women with low allopregnanolone levels, thus proving a suboptimal response to stress.
Allopregnanolone modules GABA receptors on a paradoxical manner inducing anxiety and irritability during luteal phase on women with a specific predisposal configuration of GABA receptor as those confirmed with PMDD. Overall, PMS/PMDD impairs the quality of life, thus the more we understand about its pathogeny, the easier it gets to control it. |
| first_indexed | 2024-12-17T22:31:38Z |
| format | Article |
| id | doaj.art-755918a8498c438ba75baeb149bd3648 |
| institution | Directory Open Access Journal |
| issn | 1842-8258 2069-6108 |
| language | English |
| last_indexed | 2024-12-17T22:31:38Z |
| publishDate | 2021-03-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Journal of Medical Practice |
| spelling | doaj.art-755918a8498c438ba75baeb149bd36482022-12-21T21:30:10ZengAmaltea Medical Publishing HouseRomanian Journal of Medical Practice1842-82582069-61082021-03-01161111410.37897/RJMP.2021.1.2Premenstrual syndrome and cortisolFlorica SANDRU0Mihai Cristian DUMITRASCU1Eugenia PETROVA2Adina GHEMIGIAN3Nicoleta DUMITRU4Mara CARSOTE5Ana VALEA6“Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; Elias Emergency Hospital, Bucharest, Romania “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; University Emergency Hospital, Bucharest, Romania “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; “C.I. Parhon“ National Institute of Endocrinology, Bucharest, Romania “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; “C.I. Parhon“ National Institute of Endocrinology, Bucharest, Romania “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; “C.I. Parhon“ National Institute of Endocrinology, Bucharest, Romania “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania; “C.I. Parhon“ National Institute of Endocrinology, Bucharest, Romania“Iuliu Hatieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania; Clinical County Hospital, Cluj-Napoca, RomaniaPremenstrual syndrome (PMS), including the severe subtype premenstrual dysphoric disorder (PMDD), DSM-5 category, represents a challenging combination of hormonal, environmental and neuroendocrine dysfunctions with menstrual cycle-related pattern. Controversies around the role of daily stress and associated anomalies of hypothalamic-pituitary-adrenal axis are related to the fact that stress is all the time, not just a fluctuating element. This is a narrative review on PMS/PMDD and cortisol profile. 46 articles are cited (between 2009 and 2020). PMD/PMDD underlines multiple imbalances and anomalies of the cortisol levels or its secretory pattern may be a few of them, despite the fact that multiple controversies are still present and most of studies are of limited statistical power. Women with PMS may have higher levels of cortisol in relationship to stress independently of the cycle phase, also a delay of CAR (cortisol awakening response) peak and a delayed cortisol slope during day time. It does not seem that CAR pattern is related to the phases of menstrual cycle. CAR anomalies may be associated with pain perception disturbances in PMS females. The most modern area of interest is related to allopregnanolone, a progesterone metabolite with neuroactive profile. The diurnal serum baseline cortisol and the values of cortisol after dexamethasone suppression test may be similar between patients with PMS and without, but the females with PMS that have higher allopregnanolone associate blunted values of cortisol during the night versus control (without PMS) and versus women with low allopregnanolone levels, thus proving a suboptimal response to stress. Allopregnanolone modules GABA receptors on a paradoxical manner inducing anxiety and irritability during luteal phase on women with a specific predisposal configuration of GABA receptor as those confirmed with PMDD. Overall, PMS/PMDD impairs the quality of life, thus the more we understand about its pathogeny, the easier it gets to control it.https://rjmp.com.ro/articles/2021.1/RJMP_2021_1_Art-02.pdfpremenstrual syndromecortisolpremenstrual dysphoric disorderstressnutrition |
| spellingShingle | Florica SANDRU Mihai Cristian DUMITRASCU Eugenia PETROVA Adina GHEMIGIAN Nicoleta DUMITRU Mara CARSOTE Ana VALEA Premenstrual syndrome and cortisol Romanian Journal of Medical Practice premenstrual syndrome cortisol premenstrual dysphoric disorder stress nutrition |
| title | Premenstrual syndrome and cortisol |
| title_full | Premenstrual syndrome and cortisol |
| title_fullStr | Premenstrual syndrome and cortisol |
| title_full_unstemmed | Premenstrual syndrome and cortisol |
| title_short | Premenstrual syndrome and cortisol |
| title_sort | premenstrual syndrome and cortisol |
| topic | premenstrual syndrome cortisol premenstrual dysphoric disorder stress nutrition |
| url | https://rjmp.com.ro/articles/2021.1/RJMP_2021_1_Art-02.pdf |
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