Permanently depressed nervous system could be to blame for severe cases of premenstrual syndrome (PMS), Japanese researchers say.
They found that PMS was tied to decreased activity in the autonomic nervous system - which controls the body's equilibrium - each month.
The effect was most pronounced in women with the most severe, and potentially debilitating, PMS symptoms.
The study, by Osaka's International Buddhist University, appears in the journal BioPsychoSocial Medicine.
PMS may include a whole range of symptoms - irritability, moodiness, depression, fatigue, abdominal bloating, breast swelling, general aches and decreased concentration.
While for some women PMS is a minor monthly annoyance, for others, more severe symptoms seriously disrupt their lives.
It is known that the condition is linked to hyper-sensitivity to the hormone progesterone, which is released by the body after ovulation.
However despite the number of women affected, science has yet to offer a full explanation or universal treatment.
The Japanese team measured heart rate variability and hormone levels in 62 women, and also used questionnaires to evaluate physical, emotional and behavioural symptoms.
They found that women troubled by PMS showed decreased nervous activity in the late luteal phase, which precedes menstruation.
Those with the most marked symptoms - known as premenstrual dysphoric disorder (PMDD) - had lower rates of nerve activity than the other groups during the entire menstrual cycle.
Researcher Dr Tamaki Matsumoto said the underlying biological mechanism of PMS remained unclear.
But he said the latest findings suggested that women with a lower autonomic function might be vulnerable to symptoms.