Unmasking the cycle: Premenstrual and menstrual exacerbation of psychiatric disorders and impact on female mental health

Figure 2 Conceptual model of premenstrual exacerbation and premenstrual dysphoric disorder. This figure presents a layered conceptual model illustrating how hormonal, psychological, and social factors interact to form an integrated vulnerability that contributes to clinical outcomes such as premenstrual exacerbation and premenstrual dysphoric disorder. The model emphasizes the convergence of multiple biopsychosocial influences in shaping premenstrual psychiatric symptoms. PME: Premenstrual exacerbation; PMDD: Premenstrual dysphoric disorder; HPA: Hypothalamic-pituitary-adrenal axis.