Unraveling the complexity of premenstrual dysphoric disorder: A biopsychosocial perspective

Premenstrual Dysphoric Disorder (PMDD) is a complex, cyclical condition marked by severe mood disturbances, physical discomfort, and significant impairments in daily functioning. Adopting a biopsychosocial approach, this narrative review examines research from 2017 to 2024 selected from PubMed, PsycINFO, and Google Scholar, emphasizing adult women aged 18 and above to elucidate the multifactorial nature of PMDD across biological, psychological, and social dimensions. Biologically, hormonal fluctuations, particularly involving estrogen and progesterone, alongside genetic factors, contribute to the disorder's onset and severity, with neurotransmitter imbalances (notably serotonin) exacerbating mood-related symptoms. Psychologically, personality traits such as neuroticism and perfectionism intensify emotional reactivity, while comorbid anxiety and mood disorders often heighten symptom severity and complicate management. Socially, cultural stigmas around menstruation, variable access to social support, and socioeconomic disparities further influence symptom manifestation and treatment accessibility, often leading to delayed diagnosis and inconsistent care. Findings underscore the necessity for a holistic, integrated treatment model that addresses the biological vulnerabilities, psychological predispositions, and social constraints experienced by individuals with PMDD. This paper advocates for personalized, multimodal therapeutic approaches that consider the full spectrum of biopsychosocial influences to enhance quality of life and treatment efficacy for those affected.