What is premenstrual syndrome?

Premenstrual syndrome, also known as PMS, is a combination of symptoms that women experience a week or more before their menstrual cycle. Most women experience at least one or more symptoms each month. Some women experience debilitating PMS where they are unable to go to work or school.

Causes of premenstrual syndrome

The cause of PMS is unknown, but hormonal changes can trigger symptoms. During the second half of the menstruation cycle, your levels of the hormone progesterone increase. Right before you begin to bleed, your levels of progesterone and estrogen drop. These changes in your hormone levels likely cause PMS symptoms.

Risk factors for premenstrual syndrome

Risk factors for premenstrual syndrome include:

  • PMS is most common between the ages of 25-40
  • Women who suffer from depression or have a personality disorder are more likely to develop PMS
  • Women who are under higher levels of stress are more likely to develop PMS
  • Women who have lower levels of vitamins or minerals such as magnesium, manganese or vitamin E, are more likely to develop PMS
  • Women who consume a diet high in sodium and sugar are more likely to experience mood changes and fatigue associated with PMS

Symptoms of premenstrual syndrome

Symptoms of PMS may include:

  • Tender breasts
  • Diarrhea
  • Abdominal cramping
  • Headache
  • Backache
  • Intolerance for noise or light
  • Clumsiness
  • Fatigue
  • Problems with sleep
  • Food cravings
  • Mood swings
  • Depression or feeling sad

Symptoms of PMS can change month to month and as you get older. No two women experience PMS exactly the same symptoms.

Diagnosis of premenstrual syndrome

Your doctor will likely diagnose PMS during a clinic visit after:Evaluating your symptoms, running diagnostic testing and taking a full medical history. 

Your doctor may recommend recording your symptoms, as well as cycle start and finish date, on a calendar for two or more cycles. This exercise will help your doctor see patterns that arise during certain periods of your cycle. If diagnostic screening is needed, your doctor may order a thyroid function test or mood screening test to determine if other conditions are causing your symptoms.

Treatment of premenstrual syndrome

Some women do not need to treat their PMS symptoms, while others need treatment to be able to continue their daily routine. Lifestyle changes such as reducing your sugar and sodium intake and eliminating smoking and alcohol consumption can help relieve your symptoms of PMS.

Medications that can also help relieve your symptoms of PMS include:

  • Antidepressants  Antidepressants such as Prozac, Paxil or Zoloft are first-line therapy for severe PMS. Some women will have to take these medications daily, while others may be instructed to take them the two weeks before menstruation begins.
  • Non-steroidal anti-inflammatory medications (NSAIDs) – Medications such as Advil, Aleve and others may relieve pain associated with cramping as well as breast discomfort.
  • Diuretics – Diuretics can help rid the body of excess fluid that leads to swelling and bloating during PMS.
  • Prescription contraceptives – Birth control pills help to relieve symptoms related to PMS.

You may need a variety of treatments over time to effectively treat your PMS. Work closely with your doctor to determine the right treatment for you.

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