While the precise causes of Premenstrual Syndrome (PMS) are not fully elucidated, current understanding suggests a complex interplay involving heightened sensitivity within the central nervous system, hormonal fluctuations, and alterations in brain chemistry. For women predisposed to PMS, the normal cyclical hormonal shifts during the menstrual cycle are believed to trigger specific biochemical responses in the central nervous system and other target tissues, leading to the manifestation of symptoms.

A key player in these processes is serotonin, a vital neurotransmitter crucial for mood regulation. Variations in serotonin levels are strongly implicated in the exacerbation of PMS symptoms. Research indicates that women experiencing PMS often exhibit notable differences in their serotonergic system when compared to those without the syndrome.

Moreover, progesterone, primarily synthesized in the ovaries, presents an intriguing dynamic: while progesterone itself may contribute to feelings of anxiety, its metabolic byproducts often have an anxiolytic effect. Progesterone also influences the serotonin system by enhancing serotonin reuptake, thereby increasing serotonin turnover.