Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS)

PMS is a recurrent condition characterized by physical, psychological, and behavioral changes of sufficient severity to result in deterioration of interpersonal relationships and normal activity.

Signs / Symptoms

What's common signs of PMS?

Symptoms must be cyclical, beginning after ovulation and resolving shortly after the onset of menstruation. You will typically only experience these symptoms for a week or two before your period starts. The symptoms follow your menstrual cycle, so you might find they start to get better when you get your period and will usually have disappeared by the time your period is finished.

Emotional Experience

  • Tension or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Appetite changes and food cravings
  • Trouble falling asleep (insomnia)
  • Social withdrawal
  • Poor concentration
  • Change in libido

Physical and Behavioural Experiences

  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain related to fluid retention
  • Abdominal bloating
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhea
  • Alcohol intolerance

But a small number of women with premenstrual syndrome have disabling symptoms every month. This form of PMS is called premenstrual dysphoric disorder (PMDD). PMDD signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension.

Common causes

What's common causes of PMS?

It is not fully understood why women experience PMS. But it may be because of changes in your hormone levels during the menstrual cycle, several factors may contribute to the condition:

  • Cyclic changes in hormones. Some women may be more affected by these hormone changes than others.
  • Chemical changes in the brain.
  • Depression

Departments & Emergency

It is recommended to see a General Practitioner or Gynecologist if an individual has above mentioned signs/symptoms.

Diagnosis

It is based on medical history. Establishing the timing of symptoms is essential when evaluating for PMS. Symptoms must occur during the luteal phase and resolve shortly after the onset of menstruation. Diagnostic laboratory testing or imaging should be directed at ruling out alternative medical diagnoses. At least one affective symptom and one somatic symptom that cause dysfunction in social, academic, or work performance.

Treatment

It is often possible to reduce PMS symptoms with some lifestyle changes.

Modify your diet

  • Eat smaller, more-frequent meals to reduce bloating and the sensation of fullness.
  • Limit salt and salty foods to reduce bloating and fluid retention.
  • Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains.
  • Choose foods rich in calcium. If you can’t tolerate dairy products or aren’t getting adequate calcium in your diet, a daily calcium supplement may help.
  • Avoid caffeine and alcohol.

Incorporate exercise into your regular routine

Engage in at least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.

Reduce stress

  • Get plenty of sleep.
  • Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia).
  • Try yoga or massage to relax and relieve stress.

Record your symptoms for a few months
Keeping a diary of your symptoms for at least 2 to 3 menstrual cycles will help you with the GP appointment. This will allow you to intervene with strategies that may help to lessen them.

For many women, lifestyle changes can help ease PMS symptoms. However, your doctor may prescribe one or more medications for PMS depending on your symptoms. some of these may be from one of the following medication groups:

  • Antidepressants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Diuretics
  • Hormonal contraceptives

FAQ

Is my symptoms due to PMS, how can I tell?
Your doctor takes a detailed menstrual history, because the relationship between symptoms and cycle phase must be confirmed. Once the detailed menstrual and symptom history have been taken, the prospective monitoring is complete, exam and laboratory data are completed (and normal). Because some conditions may mimic PMS, including chronic fatigue syndrome, thyroid disorders and mood disorders, such as depression and anxiety. Your health care provider may order tests, such as a thyroid function test or mood screening tests to help provide a clear diagnosis.

What should I not do for PMS?
You shouldn’t smoke and drink too much alcohol.

 

References:

  1. Premenstrual syndrome: Background, pathophysiology and etiology, epidemiology. (2019, November 10). Diseases & Conditions – Medscape Reference. https://emedicine.medscape.com/article/953696-overview
  2. Premenstrual syndrome (PMS) – Symptoms and causes. (2020, February 7). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780
  3. Bodden, S. H. (2016, August 1). Premenstrual syndrome and premenstrual dysphoric disorder. AAFP American Academy of Family Physicians. https://www.aafp.org/afp/2016/0801/p236.html
  4. PMS (premenstrual syndrome). (2018, April 23). nhs.uk. https://www.nhs.uk/conditions/pre-menstrual-syndrome/
  5. UpToDate. (n.d.). https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder?search=Premenstrual%20Syndrome&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
  6. UpToDate. (n.d.). https://www.uptodate.com/contents/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics?search=Premenstrual%20Syndrome&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4
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