What is premenstrual syndrome?
Most women experience some unpleasant or uncomfortable symptoms during
their menstrual cycle. For some women, the symptoms are significant, but
of short duration and not disabling. Other women, however, may have one
or more of a broad range of symptoms that temporarily disturb normal functioning.
These symptoms may last from a few hours to many days. The types and intensity
of symptoms vary in individuals. This group of symptoms is referred to
as premenstrual syndrome, or PMS. Although the symptoms usually cease
with onset of the menstrual period, in some women, symptoms may last through
and after their menstrual periods.
Who is affected by PMS?
As many as 75 percent of women, during their reproductive years, experience
some of the common symptoms associated with PMS. Further, approximately
30 to 40 percent of these women experience symptoms so severe that they
disrupt daily activities. It is estimated that less than 10 percent of
women have symptoms so extreme that they are considered disabled by the
condition.
In general, women most likely to experience PMS symptoms are between
the ages of 20 and 40 - and particularly women from this age group who
have one child and have a history of depression in their family.
What are the symptoms of PMS?
The following are the most common symptoms of premenstrual syndrome.
However, each individual may experience symptoms differently. Symptoms
may include:
psychological
symptoms
- irritability
- nervousness
- lack of control
- agitation
- anger
- insomnia
- difficulty in concentrating
- lethargy
- depression
- severe fatigue
- anxiety
- confusion
- forgetfulness
- decreased self-image
- paranoia
- emotional hypersensitivity
- crying spells
- moodiness
- sleep disturbances
fluid retention
- edema (swelling of the ankles, hands, and feet)
- periodic weight gain
- oliguria (diminished urine formation)
- breast fullness and pain
respiratory problems
eye complaints
- visual disturbances
- conjunctivitis
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gastrointestinal
symptoms
- abdominal cramps
- bloating
- constipation
- nausea
- vomiting
- pelvic heaviness or pressure
- backache
skin problems
- acne
- neurodermatitis (skin inflammation with itching)
- aggravation of other skin disorders, including cold sores
neurologic and vascular symptoms
- headache
- vertigo
- syncope (fainting)
- numbness, prickling, tingling, or heightened sensitivity of
arms and/or legs
- easy bruising
- heart palpitations
- muscle spasms
other
- decreased coordination
- painful menstruation
- diminished libido (sex drive)
- appetite changes
- food cravings
- hot flashes
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The symptoms of PMS may resemble other conditions or medical problems.
Consult a physician for diagnosis.
What causes PMS?
Premenstrual syndrome seems to be related to fluctuations in estrogen
and progesterone levels in the body, and does not necessary denote disabled
ovarian functioning. The following have been suggested as possible
causes of PMS:
- estrogen-progesterone imbalance
- hyperprolactinemia (excessive secretion of prolactin, the hormone
that stimulates breast development)
- excessive aldosterone, or ADH (hormone that functions in the regulation
of the metabolism of sodium, chloride, and potassium)
- carbohydrate metabolism changes
- retention of sodium and water by the kidneys
- hypoglycemia (low blood sugar)
Preventing premenstrual syndrome symptoms:
For some women, making simple lifestyle changes helps to reduce the occurrence
of PMS symptoms. These changes may include:
- regular exercise (3 to 5 times each week)
- a well-balanced diet
It is generally recommended that women with PMS increase their intake
of whole grains, vegetables, and fruit, while decreasing their intake
of salt, sugar, caffeine, and alcohol.
How to diagnose premenstrual syndrome:
Aside from a complete medical history and physical and pelvic examination,
diagnostic procedures for PMS are currently very limited. Your physician
may consider recommending a psychiatric evaluation to, more or less, provide
a differential diagnosis (to rule out other possible conditions). In addition,
he/she may ask that you keep a journal or diary of your symptoms for several
months, to better assess the timing, severity, onset, and duration of
symptoms.
Treatment for PMS:
Specific treatment for PMS will be determined by your physician based
on:
- your age, overall health, and medical history
- extent of the condition
- current symptoms
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
Counseling with your physician regarding symptoms can often increase
understanding and lead to activities for stress management. Other possible
treatments for managing premenstrual syndrome symptoms may include:
- diuretic use prior to the time symptoms are usually noted (to reduce
fluid retention)
- prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications,
or NSAIDs, such as aspirin, ibuprofen) - to reduce pain
- oral contraceptives (ovulation inhibitors)
- progesterone (hormone treatment)
- changing the diet (to increase protein and decrease sugar and caffeine
intake)
- vitamin supplements (i.e., vitamin B6, calcium, and magnesium)
- antidepressants (or other medications)
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