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This review synthesizes current research progress and explores the intersecting biological pathways between PMDD and AD, with a particular focus on dynamic fluctuations in estradiol (E2) and allopregnanolone (ALLO), dysregulation of the \u03b3-aminobutyric acid (GABA)ergic system and serotonergic (5-HT) neurotransmitter systems, and sex-specific vulnerability associated with the apolipoprotein E epsilon 4 (APOE \u03f54) allele. These mechanisms suggest that PMDD may serve as a potential biological precursor state for AD, offering valuable implications for early screening and intervention. 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