Premenstrual Syndrome (PMS)

What Is It?

Premenstrual syndrome (PMS) is a collection of physical, psychological and emotional symptoms that many women experience during the one to two weeks before a menstrual period. These symptoms disappear soon after the start of menstrual bleeding.

Several theories have been proposed to explain why PMS occurs. The most popular explanation for PMS is that these symptoms are related to cyclic changes in female sex hormones, pituitary hormones, prostaglandins and certain brain chemicals known as neurotransmitters. Some researchers have suggested that PMS may be related to abnormally low blood sugar (hypoglycemia), abnormally low levels of thyroid hormones (hypothyroidism) or a diet low in B vitamins, calcium or magnesium. However, recent studies do not support these theories. Preliminary studies indicate that magnesium deficiency could play a role.

It is believed that lifestyle may play a significant role in PMS. This is because PMS symptoms appear to be most troubling in women who smoke, lead stressful lives, rarely exercise, sleep too little or whose diet is high in caffeine, alcohol, salt, red meat or sugary foods such as chocolate or candy. However, it's not clear whether these factors increase your risk of PMS or if PMS accounts for these differences in lifestyle. For example, studies looking at the influence of stress do not find a relationship between stress and the severity of PMS. It is more likely that PMS causes stress rather than that stress causes PMS.

It's possible that medications may exaggerate the symptoms of PMS. Oral contraceptives (birth control pills) have been known to cause symptoms of PMS in some women. However, some women have noticed that their symptoms improve or disappear while using birth control pills.

In recent years, there has been some controversy in the medical community about the difference between premenstrual discomfort and true PMS. This is because premenstrual discomfort is fairly common among women of childbearing age, affecting about 75% of all menstruating women. However, only about 3% to 8% of women have symptoms that are severe enough to either disrupt their personal relationships or interfere with their normal work and home responsibilities. Some doctors feel that only these women - the small percentage with severe symptoms - have true PMS. These doctors regard PMS as a severe illness that is equivalent to what psychiatrists call premenstrual dysphoric disorder (PMDD). However, other doctors use a less stringent definition for PMS, which includes mild to moderate symptoms.

Symptoms

Symptoms of PMS fall into two general categories:

Physical symptoms

• Bloating

• Breast tenderness

• Swelling of feet and ankles

• Fluid retention and weight gain

• Painful uterine cramps just before and during the first few days of menstruation

• Headaches

• Food cravings (especially for salty or sweet foods)

• Acne breakout

• Low energy or fatigue

• Palpitations

• Dizziness

• Backaches or muscle pain