Most women who menstruate regularly undergo a range of physical, psychological, and behavioral changes during the period between ovulation and menstruation. One of the first descriptions of these changes was presented by Horney in 1931 [1]. Around the same time as Horney’s description, another significant paper by Frank is often acknowledged as the first modern clinical account of premenstrual symptoms [2]. Like Horney, Frank also used the term “premenstrual tension” to highlight the cyclical emotional disturbances that occurred during the latter part of the menstrual cycle. Although these two researchers began to focus on menstruation and its associated symptoms during the same historical period, their perspectives on this condition were markedly different. The feminist psychoanalyst Karen Horney described “premenstrual tension” as a psychological response to anxieties and fantasies associated with pregnancy, as well as frustrations resulting from cultural restrictions on the expression of female sexuality, while Robert Frank, the gynecologist often credited with identifying premenstrual tension, attributed the symptoms to accumulations of the female sex hormone estrogen and advocated medical intervention. Frank considered premenstrual tension a dysfunction, Horney argued that it was not a pathological process because mood fluctuations, anxiety and irritability, occurred in otherwise healthy women. Frank’s focus shifted increasingly towards a substantial cohort of women facing diverse premenstrual disturbances. It is a well-known fact that ordinary women experience varying levels of discomfort before the onset of menstruation. These minor disruptions encompass heightened fatigue, irritability, diminished concentration, and episodes of pain. However, in a different subset of patients, the reported symptoms were serious enough to necessitate a day or two of bed rest. Among this group, pain takes center stage as the prevailing issue. Yet, another category of patients presented significant systemic disorders during the premenstrual phase. And it is precisely these latter two groups of patients that Frank aimed to shed light on, primarily from a hormonal and clinical perspective, thus laying the groundwork for an in-depth study of these disorders. However, in 1953, Greene and Dalton reasoned that emotional tension was just one of several components of this condition. They suggested that it should be more appropriately named “premenstrual syndrome” [3]. The shift from “premenstrual tension” to “premenstrual syndrome” reflects a transformative evolution in the conceptualization and understanding of the cluster of symptoms experienced by menstruating women. Originally characterized as “premenstrual tension”, the term emphasized the emotional and psychological aspects of the disturbances occurring in the latter part of the menstrual cycle. However, as subsequent research expanded the scope and recognition of diverse physical, emotional, and behavioral changes during this phase, it became evident that the term “tension” inadequately captured the complexity of the condition. This shift allowed for a more inclusive and comprehensive understanding of the condition, recognizing its multifaceted nature.

2. Definition and Diagnosis