The menstrual cycle: psychological, behavioral, physiological, and nutritional factors

The human female menstrual cycle is marked by the regular occurrence of menses appearing on average once every twenty eight days starting at puberty and ending at menopause. It is controlled by the endocrine system and requires adequate hormonal and nutritional status to function. Since the menstrual cycle is dependent on the synchronized operation between systems inputs and outputs, disturbances or system failures can occur at any point. Menstrual cycle discomfort or distress ranges from clinically defined and physiologically measurable symptoms of, for example, amenorrhoea to the more difficult to measure premenstrual dysphoria. Symptoms of premenstrual discomfort or dysphoria, commonly referred to as pre menstrual distress, premenstrual syndrome or premenstrual dysphoric disorder are physiological, behavioural and psychological in nature, commonly experienced and can range in severity from mild to debilitating. Although premenstrual disturbances have been studied extensively by researchers from many disciplines, no consensus on its aetiology exists. Nevertheless, psychological, behavioural, physiological, endocrine and nutritional factors have all been identified as relevant in either their contribution causally or as effective in the treatment of these premenstrual dysphoric disorders. The evidence of links between biochemical, nutritional and psychological variables and the premenstrual phase of the menstrual cycle are explored in this chapter. Nutritional interventions for premenstrual disorders are catching up with the previously extolled pharmacological therapies but their efficacy is also yet to be confirmed.