Definition

Premenstrual syndrome (PMS) is a disorder marked by physical and emotional symptoms. It affects women one or two weeks before the beginning of their menstrual period.

The Menstrual Flow

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Causes

The cause of PMS is unknown. It may be that a complex combination of environmental, metabolic, and behavioral factors produces a ‘vulnerability' to the hormonal changes associated with menstruation. A brain chemical, serotonin, may play a role in severe forms of PMS.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

  • Age: 25–40
  • Going off birth control pills
  • Major life stress
  • Depression

Symptoms

PMS is characterized by physical and emotional symptoms that occur in a cycle one to two weeks before menstruation begins. Symptoms, which often improve when bleeding starts, can be extremely distressing and may include:

  • Irritability
  • Mood swings
  • Anxiety
  • Depression
  • Diminished self-esteem
  • Difficulty concentrating
  • Sleep problems
  • Appetite changes (sugar and/or salt cravings; overeating)
  • Weight gain
  • Fatigue
  • Bloating
  • Headache
  • Breast swelling and tenderness
  • Palpitations
  • Dizziness
  • Gastrointestinal upset
  • Diffuse muscle pain

Diagnosis

Your healthcare provider will ask about your symptoms and medical history, and perform a physical exam.

It is a good idea to keep a record of your monthly physical and emotional symptoms. These symptoms will most likely occur one to two weeks before the menstrual period each month. When symptoms occur at the same phase of the menstrual cycle each month, PMS is a likely diagnosis.

Treatment

Many treatments have been used to relieve to relieve the symptoms of PMS. No one treatment has been found to be consistently effective for all symptoms, for all women. Treating one or two symptoms may help to alleviate the whole syndrome. Treatments include:

Stress Management

Stress may be managed through lifestyle changes. Relaxation techniques, deep breathing, massage, music, and hot baths can also help reduce stress.

Dietary Changes

Dietary changes may be helpful in relieving PMS. They include decreasing intake of salt, sugar, and caffeine. (Caffeine is found in coffee, tea, cola, diet sodas, chocolate). Eating small, frequent meals may also help.

Vitamins and Minerals

There is some evidence to suggest that the following vitamin and mineral supplements can help reduce PMS symptoms:

  • Vitamin E (400 IU) - may reduce breast tenderness
  • Calcium (1000 mg) - to decrease bloating, depression, and aches
  • Magnesium (400 mg) - to decrease pain, fluid retention, and improve mood
  • Manganese (6 mg)

Regular Exercise

Research suggests that women who engage in moderate activity suffer less PMS-related symptoms than sedentary women.

Medications

Diuretics can help reduce bloating and fluid retention. Prostaglandin inhibitors, such as Motrin,

can effectively relieve cramps, headaches, and muscle aches.

Oral Contraceptives

Combined oral contraceptives (OCPs) may help physical symptoms associated with PMS. It may be necessary to try several brands before finding one that helps. Progesterone alone may also help some women.

Antidepressants

Antidepressants such as Zoloft and Prozac are often helpful in managing the depression associated with PMS.

Sexual Activity with Orgasm

Sexual activity (including masturbation) may help relieve aching muscles and sluggish circulation. It moves blood and fluids away from congested organs.

Psychotherapy

Women with severe PMS symptoms may benefit from cognitive (behavioral) therapy. Therapy may help reduce negative emotions and enhance problem-solving skills in relationships. It may also help manage obstacles, frustrations and discomfort

Prevention

  • Manage stress.
  • Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
  • Decrease consumption of refined sugar, salt, and caffeine.
  • Engage in regular aerobic exercise.