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The increasing concentration of chemical pollutants in metropolitan air, particularly polycyclic aromatic hydrocarbons (PAHs), has generated emerging concerns regarding women’s mental health and reproductive function. Although prior research has primarily focused on respiratory outcomes, the complex effects of these compounds on regulatory body systems have received comparatively limited attention. This narrative review examines the dual mechanisms of PAHs as concurrent disruptors of the nervous and endocrine systems in the pathophysiology of menstrual mood disorders, including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Relevant literature was retrieved from Scopus, PubMed, Web of Science, and Google Scholar, with emphasis on recent publications and region-specific evidence from Iran. Analysis of the literature indicates that PAHs, through binding to aryl hydrocarbon receptors (AhR) and induction of oxidative stress in ovarian tissue, promote apoptosis of corpus luteum cells and contribute to luteal phase insufficiency. This process is associated with abrupt progesterone decline and menstrual cycle irregularities. Additionally, fine particulate matter carrying these compounds may cross the blood–brain barrier, leading to neuroinflammation and reduced expression of developmental genes in the brain, thereby lowering psychological resilience to hormonal fluctuations. Furthermore, epidemiological evidence derived from large-scale datasets and studies conducted in Tehran confirms a significant association between air pollution exposure and adverse reproductive outcomes, including stillbirth. The findings highlight the necessity of recognizing air pollution as a key environmental risk factor in the etiology of psychoneuroendocrine disorders. Implementation of emission reduction policies in urban areas represents a strategic approach to decreasing the burden of menstruation-related mood disorders.

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