Trastorno disfórico premenstrual

Abstract

Premenstrual Dysphoric Disorder (PMDD) is the pathological exacerbation of the somatic and psychological changes that occur during the normal feminine cycle's luteal phase. Included among its possible etiopathogenic mechanisms are closely related genetic, neurobiological, and endocrinological factors. This article emphasizes the role of serotonin as a moderating factor and the use of SSRI in treatment. The rapid effect of these drugs suggests an action other than anti-depressive. New studies look at an enzyme in steroid synthesis. The changes that take place during the luteal or progestational phase of menstruation have been a source of controversy in different socio-cultural and historical contexts, many with a mythological flavor. In the Bible, a menstruating woman is considered to be impure, and must not be touched by a man; a professor explains that menstruation is the crying of an unfertilized uterus; some labor laws interpret menstruation as an illness (feminine day). Hippocrates gives us the first description of this pathology, but psychiatry recognizes premenstrual syndrome as a probable psychiatric disorder only in 1980, and has recently proposed new treatment. Medical knowledge tells us that menstruation involves cyclical hormonal repercussions that affect a woman's entire organism; thus the normal variations in behavior, mood, weight, appetite, libido, and body temperature during both the follicular and luteal phases of the cycle. When these changes are extreme, they are considered to be a pathological expression of the normal feminine process, giving rise to PMDD. © 2006 Sociedad de Neurolog Psiquiatry Neurocirugbr.