PITTSBURGH (KDKA) – The week before your period, do you scream at people, throw things and just feel downright cranky and irritable?

“When it persists month after month, and it starts to interfere with their quality of life and their day-to-day routine, they seek help,” says West Penn Hospital OBGYN Dr. Eugene Scioscia.

Lots of women can relate to the moodiness of PMS, or premenstrual syndrome.

“The onset is generally four to five days before the menses and clearly go away four to five days after the onset of their menses, and it happens regularly with every cycle,” explains Dr. Scioscia. “Despite what this article has said, I think there is something to it.”

A large review of 47 studies says the existing literature does not support a premenstrual negative mood syndrome, even though likely biological explanations exist.

“Something about the hormones, estrogen and progesterone, affecting what we call neurotransmitters, which is the way nerve cells communicate, throughout our body, including our brain,” he says.

Part of why evidence could not be found for PMS is not because it doesn’t exist, but because the studies reviewed were so different in sample size and methods.

The authors conclude PMS needs more study.

“I think it varies from culture to culture, and we may be seeing something here that is a cultural difference,” says Dr. Scioscia.

They say the widespread cultural notion of behaviors related to PMS is essentially a cop out.

“I believe people just try to act cranky in order to get attention,” says one woman walking in Bloomfield.

“We don’t want to attribute something to PMS when it’s something else altogether. I think that’s the point of this article,” says Dr. Scioscia.

He points out that the more severe PMDD, or premenstrual dysphoric disorder is an established psychiatric diagnosis, and he would like to think the psychiatrists carefully considered this.

For his patients he diagnoses with PMS, he recommends exercise and a high protein, low sugar and low caffeine diet.