Premenstrual Syndrome (PMS): An Introduction

Premenstrual syndrome, often abbreviated as PMS, is a collection of physical and emotional symptoms that commonly affect women in the days leading up to their menstrual period. These symptoms typically subside once menstruation begins, providing a symptom-free interval until they return again.

PMS is a prevalent condition, with approximately 75% of women experiencing mild symptoms and around 20-30% facing more severe manifestations. For 8% of women, severe PMS significantly impacts their quality of life.

Understanding PMS: What Research Tells Us

PMS is a complex condition influenced by both physical and emotional factors. Research indicates that women with PMS exhibit hypersensitivity to their own normal cyclic hormones, specifically progesterone and estrogen, during their menstrual cycle. Additionally, neurotransmitters like serotonin and gamma butyric acid play a role in PMS. Importantly, these symptoms do not occur during pregnancy or after menopause.

While the exact cause of PMS remains unclear, effective management is possible through medication and other strategies.

Common Symptoms of PMS

PMS symptoms can vary from woman to woman and encompass both physical and mood-related manifestations.

Physical Symptoms of PMS:

1. Abdominal bloating
2. Acne
3. Clumsiness
4. Digestive issues (constipation and diarrhea)
5. Fluid retention
6. Weight gain
7. Breast tenderness or swelling
8. Joint or muscle pain
9. Fatigue
10. Sleep disturbances
11. Food cravings
12. Headache and migraine
13. Hot flushes or sweats
14. Increased appetite
15. Heightened sensitivity to sounds, light, and touch

Mood Symptoms of PMS:

1. Anxiety
2. Confusion
3. Depression and lowered mood, including thoughts of self-harm
4. Difficulty concentrating and memory lapses
5. Decreased self-esteem and confidence, leading to social isolation
6. Altered sexual desire
7. Feelings of loneliness and paranoia
8. Irritability, including angry outbursts
9. Mood swings and weepiness

Factors Contributing to PMS

The precise cause of PMS remains unknown, but various factors may contribute to its development:

1. Stress
2. Psychological state
3. Poor physical health
4. Overweight or obesity (women with a BMI over 30 are three times more likely to experience PMS)
5. Smoking (smokers have a higher risk of severe PMS)
6. Family history and genetics
7. Cultural and social environment

It’s worth noting that past theories about PMS causes, including estrogen excess, progestogen deficiency, vitamin B6 deficiency, abnormal glucose metabolism, and electrolyte imbalances, have been debunked.

Premenstrual Dysphoric Disorder (PMDD)

Between 3% and 8% of menstruating women suffer from severe PMS, often referred to as premenstrual dysphoric disorder (PMDD). PMDD symptoms can significantly impact mental health and daily functioning, sometimes rendering affected women unable to perform their regular activities.

Diagnosing PMS

Diagnosing PMS does not rely on specific tests, as hormone levels typically fall within the normal range. Diagnosis is primarily based on a thorough medical history and symptom description.

Keeping a daily symptoms diary for at least two menstrual cycles is a recommended approach to help identify PMS. This diary should include menstrual cycle details, such as the first and last days of menstruation. If symptoms persist beyond menstruation, further investigations may be necessary.

If you are unsure whether you have PMS or need assistance in understanding your symptoms, consult your healthcare provider.

Managing PMS

While there is no cure for PMS, symptoms can often be effectively managed through various approaches:

1. Lifestyle Changes:

• Regular exercise (at least 3 times a week, daily exercise can be even more beneficial)
• Smoking cessation
• Limiting caffeine and alcohol intake in the two weeks before your period
• Adequate sleep
• Stress management through counseling, cognitive-behavioral therapy (CBT), tai chi, meditation, mindfulness, walking, or gardening

2. Dietary Modifications:

• Eating smaller, more frequent meals
• Reducing salt consumption
• Incorporating fresh fruits, vegetables, and whole grains into your diet
• Increasing dairy intake
• Avoiding keeping high-fat and high-sugar foods at home
• Recording food choices in your PMS diary to monitor high-fat and high-sugar snacking

3. Medication and Hormone Treatments:

Several medications and hormone treatments are available to alleviate PMS symptoms:

• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, sertraline, paroxetine, and escitalopram
• Combined oral contraceptive pills
• Agents that suppress ovulation, like GnRH analogues and danazol

4. Complementary Medicine:

Many women find relief from PMS symptoms through complementary therapies like cognitive-behavioral therapy and various herbal remedies. Calcium, vitamin D, vitex agnus-castus, gingko biloba, evening primrose oil, lemon balm, curcumin, vitamin B6, isoflavones, St. John’s wort, and wheatgerm have shown some benefits in reducing PMS symptoms.

When considering complementary therapies, it is crucial to consult with a qualified professional and inform your doctor about any herbal or complementary treatments you are using. Complementary therapies should be regarded with the same level of seriousness as conventional medicines.

Incorporating a combination of these approaches, you may find the right balance to effectively manage your PMS symptoms. Continuously track your symptoms in your PMS diary while exploring these strategies and treatments, and consult your healthcare provider during this process.

In conclusion, while PMS may not be preventable, it can be successfully managed with appropriate medical care and lifestyle adjustments. By maintaining a balanced diet rich in essential nutrients and being mindful of iodine consumption, you can improve your overall well-being. Keep in mind that most dietary restrictions associated with PMS are temporary, and adopting these changes can lead to a healthier and more balanced lifestyle.