Premenstrual Syndrome (PMS)

What is PMS?

Premenstrual Syndrome or PMS has various painful symptoms extending from mood swings to food cravings, and is known to affect an estimated 3 of every 4 menstruating women. PMS typically starts midway through the normal cycle and continues until menstruation has begun. PMS can occur in any woman during her reproductive years and would still unfortunately continue even after the onset of menopause.

Premenstrual Syndrome tends to persist in predictable patterns; however, the emotional and physical changes may be severe in some months and just slightly noticeable in others. The good thing about PMS is that various treatments have been developed to reduce and manage its symptoms.

According to the study of the American College of Obstetricians and Gynecologists, at least 85% of women experience not less than 1 PMS symptom in each of their monthly cycles. Most women do not need treatment; however, approximately 3% to 8% undergo the more severe form of PMS, called the premenstrual dysphoric disorder or PMDD.

Symptoms of PMS

PMS causes symptoms in all the different aspects of a woman’s life – physical, emotional, behavioral or mental. As documented through different studies, there are over 150 PMS symptoms. A lot of women usually experience a few symptoms, but others are unfortunate enough to undergo a dozen or even more symptoms at one time.

Physical Symptoms

The physical symptoms of PMS may include:

• Fatigue
• Acne
• Back pain
• Breast tenderness
• Abdominal bloating
• Constipation or diarrhea
• Headache or migraine
• Weight gain (Fluid retention)
• Muscle or joint pain

Emotional / Mental / Behavioral Symptoms

PMS will also affect your emotions and mental activity, as well as the direction of your behavior. Symptoms under these may include:

• Mood swings
• Depression
• Tension or anxiety
• Indecision
• Poor concentration
• Social Withdrawal
• Irritability or anger
• Insomnia
• Decrease sex drive
• Unexplainable crying
• Food cravings

What causes PMS?

The exact cause of PMS is still unknown to researchers. It is still impossible to know those exact causes; however, there are some factors that may actually contribute to the condition. Such factors may include:

• Periodic hormonal changes. The symptoms of PMS changes as hormones fluctuate, and then abruptly disappear with pregnancy and menopause.
• Chemical changes in the brain. Changes in the level of serotonin, a chemical that affects mood states in the brain, can trigger several PMS symptoms. A decrease in serotonin may account to PMS depression, including sleeping problems, fatigue, and even food cravings.
• Stress. Stress most likely intensifies some of the PMS symptoms.
• Bad eating habits. Low levels in the intake of vitamins and minerals have been generally linked to some of the PMS symptoms. Other factors which are likely to contribute to PMS may include eating of salty foods, which causes the retention of fluid, and drinking caffeinated and alcohol liquors, which disturbs a woman’s energy and mood levels.
• Depression. Sometimes undiagnosed depression is present among women with intense PMS, but depression alone does not contribute in all of the symptoms.

Diagnosis of PMS

Since there are no laboratory exams to diagnose if a patient has PMS, the most useful tool that a doctor may recommend is a menstrual diary. Signs and symptoms for at least two menstrual cycles will be recorded in the diary. The first day that PMS symptoms are noticed, including the day they disappear will have to be noted. The beginning and end of a menstrual period will have to be marked as well. Keeping a menstrual diary will not only help the doctor, but also the aids in the understanding of the patient’s own moods and body. After the diagnosis of the PMS is made and explained, it will be easier for the patient to cope up with the symptoms.

A questionnaire may also be asked by the doctor for the patient to complete. The questions included pertain to PMS symptoms that have been experienced by the patient for the last two weeks. This then gives the doctor more information for further evaluation.

Treatment of PMS

One or more medications may be prescribed for PMS. The success rate of each would still vary from one woman to another. The most commonly prescribed medications by the doctors for PMS may include:

• Antidepressants. Selective serotonin reuptake inhibitors or SSRIs, which have been great in the reduction of certain symptoms such sleep problems and fatigue, are the very first line agents that can treat intense PMS or PMDD. These drugs are usually taken daily; however, some women with PMS can only take them with a limit of two weeks before menstrual period begins.
• Nonsteroidal anti-inflammatory drugs or NSAIDs. An easing in the cramping and breast discomfort of women is caused by the intake of NSAIDs on or before the onset of the menstrual period.
• Diuretics. Taking diuretics or water pills such as the spironolactone can help in the easing of some of the symptoms of PMS. It can also help in the emission of excess water out of the body through the kidneys.
• Oral contraceptives. This medication stops ovulation and helps in the stabilization of hormonal swings, therefore helping in the relief from PMS symptoms.
• Medroxyprogesterone acetate or Depo-Provera. An injection that is used to stop ovulation temporarily; however, Depo-Provera causes an increase in headache, appetite, depression and some of the other symptoms of PMS.

How to prevent PMS

In order to prevent and manage PMS, a healthy lifestyle should be practiced. These practices should include:

• Regular exercise
• An emotional support group
• Avoiding salt
• Reducing caffeine intake
• Reducing alcohol intake
• Reducing intake of refined sugars
• Quitting smoking

All of the above have been suggested as a help for reducing PMS symptoms in some women. Moreover, some researches also recommend that the intake of vitamin E, vitamin B6, magnesium, and calcium can have its benefits.

References:

http://www.epigee.org/menstruation/pms.html

http://www.medicinenet.com/premenstrual_syndrome/page6.htm

http://www.medicalnewstoday.com/articles/154699.php

http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.cfm