What is Premenstrual Syndrome?

Premenstrual syndrome (PMS) is the term given to symptoms (physical, psychological and behavioural) experienced by a woman during her menstrual cycle. The symptoms may start a few day or even two weeks before the monthly menstrual cycle and usually stop when menstruation begins. In some women, the symptoms may last for a few days after the start of menstruation.

Cause of PMS

The exact cause of PMS is not known, but changes in hormonal levels are believed to cause PMS. There is no conclusive evidence to prove that changes in hormone levels play a role in PMS. There is also no explanation for the fact that different women respond differently to changes in their hormonal levels. Besides hormones other factors that are believed to influence PMS include social, cultural, biological and psychological factors.

According to research, about 75% of women experience some symptoms of PMS (that may be mild to moderate in severity), about 20% to 50% find that symptoms disrupt their daily life and prevent them from doing their regular activities and about 3% to 5% have severe symptoms that can incapacitate them.

PMS is more likely in women:

• between late 20s and early 40s
• with at least one child
• with a history of major depression or postpartum depression (family history of depression also makes you more likely to experience symptoms of PMS)
• women with a history of any affective mood disorder

Symptom of PMS

Symptoms of PMS may vary from mild to severe. PMS can cause physical, behavioural and emotional and cognitive symptoms.

Common physical symptoms of PMS include:

• swelling of breast and tenderness
• bloating sensation and weight gain (because of water retention)
• changes in bowel habits (may be diarrhoea or constipation)
• acne
• discharge from nipple on pressing the nipples or breasts (if you have discharge that occurs spontaneously without pressing on the nipple, consult a health care professional)
• food cravings, such as for sweet or salty foods
• changes in sleep pattern (such as feeling excessively sleepy or not being able to sleep well)
• feeling tired, fatigued or a lack of energy
• decreased interest in sex
• pain and aches, such as headaches, breast tenderness, aching muscles and joints or cramps and low back pain.

Common cognitive and emotional symptoms of PMS include:

• feeling depressed, sad, hopeless
• changes in mood such as anger, irritability, anxious
• mood swings.
• inability to concentrate or focus on any work

In occasional cases, emotional and cognitive symptoms can be severe and incapacitating. If you experience severe emotional and cognitive symptoms, it is known as premenstrual dysphoric disorder (PMDD). Some women may experience worsening of PMS symptoms in their late 30s and 40s (in the perimenopausal period before the onset of menopause).

Treatment

Premenstrual syndrome (PMS) cannot be cured, but with treatment the symptoms can be controlled in most women so that they do not interfere with daily life. Treatment options of PMS include:

• diet and lifestyle changes
• medications
• complementary medicines
• psychological therapy

No one type of treatment has been shown to be helpful in all women with PMS. The success of each type of treatment in providing relief from PMS symptoms is variable from woman to woman.