Interacció de les hormones a l’eix hipotàlem-hipòfisi-ovari durant el cicle menstrual i la seva relació amb el trastorn disfòric premenstrual en persones amb ovaris

Abstract

This literature review addresses the functioning of the menstrual cycle from a physiological and endocrine

perspective and how it can lead to different conditions in people with ovaries (throughout the paper, 'people

with ovaries' refers to cisgender women, non-binary people, and transgender people who have not started

hormonal treatment that suppresses ovarian function). The hypothalamic-pituitary-ovarian (HPO) axis, the

gonadotropin and ovarian hormones, the follicles, or the corpus luteum, are essential elements for

understanding the functioning of the menstrual cycle. From the HPO axis, a coordinated pulse of action and

secretion of gonadotropin and ovarian hormones is set in motion, interacting and modifying their

concentrations cyclically.

The menstrual cycle is divided into two simultaneous cycles, the ovarian cycle and the endometrial cycle.

Between days 14 to 28 of the menstrual cycle, which align with the luteal phase of the ovarian cycle, and the

secretory phase of the endometrial cycle, the ovarian hormones, estrogen and progesterone, fluctuate,

increasing and decreasing their levels, which can cause posible alterations in the days before menstruation.

These alterations can arise diseases that affect the body physically, such as dysmenorrhea, hypermenorrhea,

polycystic ovaries, endometrial polyps, or diseases that affect it psychologically, such as premenstrual

dysphoric disorder (PMDD). PMDD is a severe variation of premenstrual syndrome, i.e., a disorder of the

luteal phase of the menstrual cycle, characterized by severe physical, affective or behavioral symptoms that

impair daily activities and quality of life.

Defining, diagnosing, or managing premenstrual disorders remains a challenge for clinicians, even though they

are common and have a functional impact similar to that of major depression. Throughout the paper, current

facts and studies are presented to enhance understanding of potential factors contributing to PMDD and

potential improvements in diagnosis and treatment approaches. Currently, there is still a lot of stigma and

misinformation regarding menstrual health issues. However, it seems that slowly we are moving towards an

increasingly inclusive and egalitarian future, giving hope for the eradication of all taboos and the ability to live

a peaceful and pain-free life

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