Premenstrual Syndrome - Risk Factors

Highlights	Risk Factors	Other Treatments
Introduction	Complications	Medications
Symptoms	Treatment	Resources
Diagnosis	Lifestyle Changes	References
Causes	Therapy

Risk Factors

Premenstrual syndrome (PMS) is reported in women in many cultures worldwide. About 80% of women in their reproductive years experience some emotional and physical symptoms before their periods that impair daily activities. An estimated 30% of women feel they need treatment for symptoms. And, between 3 - 8% of women report very severe symptoms, notably premenstrual dysphoric disorder (PMDD). A number of factors may put a woman at higher risk for PMS.

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Age

The risk for severe PMS is higher in younger women and onset usually begins around the mid-twenties. (In one survey of adolescents, however, 88% reported moderate to severe premenstrual symptoms.) In any case, women with PMS typically first seek treatment in their 30s.

Although some evidence has suggested that PMS symptoms diminish after age 35, a 2002 study reported that 6.4% of women between ages 36 and 44 had a diagnosis of premenstrual dysphoric disorder. Naturally, PMS and any manifestation of it end at menopause.

Psychologic Factors

Psychologic factors often play an important role in a woman's risk for PMS and premenstrual dysphoric disorder. It should be noted, however, that they are unlikely to be the cause in most cases. Studies continue to demonstrate that strong psychologic support can significantly reduce PMS symptoms.

Depression. One large study of women between 36 and 44, reported that 25% had symptoms indicative of major depression. Such women were significantly more likely to have PMS than those who were not depressed. Premenstrual dysphoric disorder can occur without any history or presence of major depression. Nevertheless, major depression is very common with PMDD.

Studies have specifically found a high prevalence of premenstrual dysphoric disorder in women who also suffer from seasonal affective disorder (SAD). This is a form of depression characterized by annual episodes of depression during fall or winter that remit in the spring or summer when daylight hours increase. In fact, some studies suggest that women with both may share genetic factors that make them vulnerable to these forms of depression.

Personality Factors Some people cite studies showing an increased incidence of low self-esteem in women who report severe premenstrual symptoms. They argue that perhaps most cases can be remedied with self-reassessment therapies that build confidence. (It is, of course, also possible that regular, physical symptoms that impair normal activities can have a significant negative effect on confidence.)