Pre-Menstrual Syndrome (PMS)

What is Pre-Menstrual Syndrome (PMS)?

In the days leading up to a period commencing, approximately 20-30% of women experience a range of physical and emotional symptoms called premenstrual syndrome (PMS). These symptoms interfere with a woman’s quality of life. Over 80% of women have at least one premenstrual symptom. Symptoms typically occur 3-10 days prior to a period beginning and generally cease once the bleeding begins.

What are Pre-Menstrual Syndrome (PMS) symptoms?

Symptoms can vary in intensity and vary between cycles. They include:

• abdominal bloating
• breast tenderness and swelling
• fluid retention
• skin problems such as acne
• lethargy, tiredness
• increase in weight
• headaches
• change in bowel habits – diarrhoea or constipation
• generalised body aches

Emotional symptoms include:

• anxiety/nervous tension
• irritation
• difficulty with concentration
• mood swings
• depression
• aggression
• decrease in libido

Diagnosis

The cause of PMS is not clear. There appears to be a complex interaction between certain chemicals in the brain and progesterone resulting in natural hormone fluctuations. There are no blood tests that are helpful – in particular, measuring hormone levels in unhelpful.

PMS does not occur if a woman is not ovulating or is post-menopausal.

It is thought that certain factors such as stress levels, psychological state, poor general health, genetic history and social or cultural environments may influence the development of PMS.
Women who have an increased BMI and those who smoke are more likely to be affected.

Treatment options?

There are many angles to look at with the treatment of PMS. A clear diagnosis of PMS needs to be made before treatment is considered. Certainly, being physiologically active, maintaining a healthy lifestyle and reducing stress levels can help.

Medications can include:

• hormone treatment such as the oral contraceptive pill which can suppress ovulation and decrease the hormone levels of the premenstrual phase
• over the counter medications such as Ibuprofen and aspirin to help reduce aches and pains
• SSRI medication, anti-depressants and anti- anxiety drugs have been shown in a number of studies to be highly effective
• natural therapies such as vitamin B6 and Evening Primrose Oil can be effective for women who have mild symptoms