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PREMENSTRUAL SYNDROME (PMS)

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PREMENSTRUAL SYNDROME (PMS)

Premenstrual syndrome describes the physical and emotional symptom that a woman may experience one to two weeks before her menstrual cycle.

  • It is a very common condition and it estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.
  • Symptoms often vary between women and resolve around the start of bleeding.
  • A more severe form of PMS that has greater psychological symptoms is the premenstrual dysphoric disorder (PMDD).
  • PMDD affects three to eight percent of premenopausal women.
  • The physical and emotional changes experienced in PMS may vary from just slightly noticeable all the way to intense.
  • PMS occurs more in women in their late 20s and early 40s.

CAUSES

The exact cause of premenstrual syndrome is unknown, but several factors may contribute to the condition:

  • Changes in hormone during the menstrual cycle seem to be an important factor. Levels of estrogen and progesterone increase during certain times of the month. An increase in this hormones can cause mood swings, anxiety, and irritability.
  • Serotonin levels affect mood. Serotonin is a brain chemical that is thought to play a crucial role in moods, emotions, and thoughts.  Fluctuations of serotonin could trigger PMS symptoms.
  • Stress and emotional problems, such as depression, do not cause the condition but may make the symptoms worse.

Factors that may increase your chance of having PMS are:

  • A family history of PMS
  • A family history of depression
  • Have a past medical history of either postpartum depression or a mood disorder.
  • Have at least 1 child.

SYMPTOMS

Emotional symptoms may include:

  • Change in interest in sex
  • Poor concentration
  • Crying spells
  • Mood swings and irritability or anger
  • Appetite changes and food cravings
  • Insomnia
  • Depressed mood
  • Tension or anxiety
  • Social withdrawal

Physical symptoms

  • A headache
  • Fatigue
  • Joint or muscle pain
  • Breast tenderness or swelling
  • Acne flare-ups
  • Alcohol intolerance
  • Lower back pain
  • Constipation
  • Bloating

The exact symptom and its severity vary from woman to woman. Most women with PMS only experience a few of the possible symptoms, in a relatively predictable pattern.

You should see your doctor if the symptoms start to affect your daily life, or if the symptoms don’t go away.

DIAGNOSIS AND TREATMENT

No unique physical finding or lab tests exist to physically diagnose PMS.

Your doctor may have you keep a diary of your symptoms or use a calendar to record your symptoms for at least two menstrual cycles to help establish a premenstrual pattern.  You will be expected to note the day that you first notice PMS symptoms and the day they disappear. Also the days your period starts and ends.

Your doctor may ask you for any family history of depression or mood disorder. This may help in determining whether your symptoms are that of PMS or another condition. Certain conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders, pregnancy. The doctor may order a thyroid hormone test, a pregnancy test, and possibly a pelvic exam to check for any gynecological problems.

TREATMENT

Lifestyle changes may be enough to relieve symptoms in certain women. But depending on the severity, your doctor may prescribe one or more medications. Such as:

  • Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) which includes fluoxetine, paroxetine, and sertraline have been successful in reducing mood symptoms.
  • NSAIDs such as ibuprofen, or naproxen can ease cramping
  • Hormonal contraceptives to stop ovulation and bring relief from PMS symptoms

Lifestyle changes may include:

  • Drinking plenty of fluids
  • Eating a balanced diet to improve overall health
  • Taking supplements such as folic acid, vitamin B-6, calcium, and magnesium
  • Sleeping at least eight hours per night to reduce fatigue
  • Exercising