Liu Qing, Lin Yuhang, Zhang Wenjuan
College of Education, Zhejiang University of Technology, Hangzhou, China.
Mental Health Education Center, Xidian University, Xi'an, China.
Heliyon. 2024 Nov 12;10(22):e40233. doi: 10.1016/j.heliyon.2024.e40233. eCollection 2024 Nov 30.
Premenstrual syndrome (PMS) encompasses a range of emotional, physiological, and behavioral symptoms that occur during the luteal phase of the menstrual cycle (MC) and resolve with the onset of menstruation. These symptoms, which can include fatigue, physical pain, anxiety, irritability, and depression, significantly affect women's daily lives and overall well-being. In severe cases, PMS can progress to premenstrual dysphoric disorder (PMDD), profoundly impairing quality of life. Despite its prevalence, the neural mechanisms underlying PMS-particularly those related to stress-are not fully understood.This review aims to explore the complex interactions between PMS and stress, with a focus on the hormonal pathways involved. We propose that abnormal stress coping styles and stress reactivity patterns, collectively referred to as stress dysfunction, are crucial factors influencing women's vulnerability to PMS. We examine the relationship between PMS and stress from four perspectives: (1) PMS shares neuroendocrine metabolic circuits based on hormonal fluctuations with stress reactivity systems; (2) there is comorbidity between PMS and stress-related disorders; (3) PMS itself may act as a stressor, potentially creating a negative feedback loop that exacerbates symptoms; and (4) biofeedback training used for stress disorders may be effective in treating PMS. By providing a detailed analysis of stress-related hormonal changes and their effects on PMS, this review offers new insights into the physiological processes underlying PMS. Understanding these interactions may inform the development of targeted interventions and improve the quality of life for women affected by PMS.
经前综合征（PMS）包括一系列在月经周期（MC）黄体期出现并在月经开始时缓解的情绪、生理和行为症状。这些症状包括疲劳、身体疼痛、焦虑、易怒和抑郁等，会显著影响女性的日常生活和整体幸福感。在严重情况下，PMS可发展为经前烦躁障碍（PMDD），严重损害生活质量。尽管其发病率很高，但PMS潜在的神经机制，尤其是与压力相关的机制，尚未完全了解。本综述旨在探讨PMS与压力之间的复杂相互作用，重点关注其中涉及的激素途径。我们认为，异常的压力应对方式和压力反应模式，统称为压力功能障碍，是影响女性易患PMS的关键因素。我们从四个角度审视PMS与压力之间的关系：（1）PMS基于激素波动与压力反应系统共享神经内分泌代谢回路；（2）PMS与压力相关疾病之间存在共病现象；（3）PMS本身可能作为一种压力源，潜在地形成一个加剧症状的负反馈回路；（4）用于治疗压力障碍的生物反馈训练可能对治疗PMS有效。通过详细分析与压力相关的激素变化及其对PMS的影响，本综述为PMS潜在的生理过程提供了新的见解。了解这些相互作用可能为制定有针对性的干预措施提供依据，并改善受PMS影响女性的生活质量。
