Schagen van Leeuwen J H, te Velde E R, Koppeschaar H P, Kop W J, Thijssen J H, van Ree J M, Haspels A A
Department of Obstetrics and Gynaecology, St. Antonius Ziekenhuis Nieuwegein, The Netherlands.
J Psychosom Obstet Gynaecol. 1993 Jun;14(2):91-109. doi: 10.3109/01674829309084433.
To both patients and physicians it seems natural to attribute adverse premenstrual phenomena to cyclic fluctuations of hormones produced by the ovary. This seems so plausible that, although the endocrine mechanism that causes premenstrual syndrome remains unknown, the condition itself is often treated with hormonal substances. Psychosocial factors are thus considered to be of only secondary importance. They may play a role as a contributing factor, to the 'real' cause of premenstrual syndrome they are not an essential ingredient. The aim of this review article is to examine how strong the evidence is for the possible existence of an endocrine factor as the causative agent in premenstrual syndrome. Using an epidemiological approach we conclude that the continuing search for the responsible mechanism that causes premenstrual syndrome may very well be an endocrine 'Holy Grail'. Human behavior cannot be understood within a single (hormonal) frame of reference. Cyclical ovarian activity is only one of the etiological factors in premenstrual syndrome. Unravelling the pathogenesis of premenstrual syndrome requires a multidisciplinary approach.
对于患者和医生而言，将经前不良现象归因于卵巢产生的激素的周期性波动似乎是自然而然的。这似乎非常合理，以至于尽管导致经前综合征的内分泌机制尚不清楚，但该病症本身通常仍用激素类物质进行治疗。因此，社会心理因素仅被认为具有次要重要性。它们可能作为一个促成因素发挥作用，但对于经前综合征的“真正”病因而言，它们并非关键要素。这篇综述文章的目的是研究作为经前综合征致病因素的内分泌因素可能存在的证据有多充分。通过采用流行病学方法，我们得出结论，持续寻找导致经前综合征的责任机制很可能是一个内分泌领域的“圣杯”。人类行为无法在单一（激素）参照系内得到理解。卵巢的周期性活动只是经前综合征的病因之一。阐明经前综合征的发病机制需要多学科方法。
