PREMENSTRUAL SYNDROME (PMS)

What is PMS? PMS is a name given to a group of physical and emotional symptoms experienced by a large number of women in relation to their menstrual cycle. These women experience a variety of regular, unpleasant symptoms that begin between 7 to 10 days before the onset of menstruation. Women with PMS can experience a range of symptoms, from feeling nervous, irritable, anxious and depressed, to having headaches, swelling of the ankles and breast pain. These complaints usually disappear a few hours after bleeding has started.

What Are The Signs And Symptoms Of PMS? The signs and symptoms of PMS differ from woman to woman, and also from cycle to cycle. The severity of the symptoms range from being minor to severe enough to disturb everyday functioning. Significant for a diagnosis is the cyclic occurrence of the complaints; many women can trace and predict a pattern once they chart their symptoms for three months. The symptoms gradually appear from a few hours to more than 10 days before the onset of menstruation, and often stop when bleeding starts. Most women will have at least 3 days within one cycle free of any symptoms. Symptoms of PMS include: 1) mood alteration and psychological effects, such as nervousness, irritability, agitation, anger, aggression, sleeplessness, difficulty in concentrating, confusion, lethargy, depression and fatigue; 2) complaints related to fluid retention, such as ankle swelling, transient weight gain, urinary difficulties, breast fullness, and swollen, painful joints; 3) neurologic and vascular complaints, such as headache, vertigo, fainting, heart palpitations (heart pounding), easy bruising, seizures and difficulties with coordination; 4) gastrointestinal problems, such as constipation, nausea, vomiting, cravings and binges for sweets or salt; 5) skin problems, such as acne and hives; 6) respiratory complaints, such as allergies, sinus problems and a sore throat; 7) eye disturbances, such as visual problems and conjunctivitis (inflammation of the eye); 8) and pelvic heaviness and backache. With the onset of menstruation, some women develop cramps. PMS should not be set equal to menstrual cramps, since some women can have PMS, but totally pain-free menses, or severe menstrual pains without any premenstrual distress.

What Causes PMS? Recent data suggest that women with PMS metabolize progesterone differently, causing an imbalance of estrogen and progesterone, two key hormones which affect the menstrual cycle. However, PMS is considered to have many factors which contribute to its development. These include an unhealthy diet and a stressful lifestyle. However it is important to realize that there is no generalized consensus on the cause of PMS. In some countries, PMS is a condition that is non-existent and even unknown.

How Is PMS Treated? Treatment for PMS includes trying to re-balance a woman's hormone levels through the use of oral contraceptives. Natural progesterone therapy has also been effective for some women. Diet changes (decreasing sugars, increasing essential fatty acids, eliminating caffeine) and supplementing with vitamin B complex and magnesium may help. Life-style changes, i.e. stress reduction, increased exercise, or counseling can be undertaken. Relief of symptoms of fluid retention may involve reduction of sodium intake and using a diuretic. Tranquilizers may be used for nervousness and irritability and antidepressants (e.g. Prozac [fluoxetine]) may be prescribed for psychologically related symptoms of PMS.