Overview
Premenstrual syndrome, commonly known as PMS is characterized by a set of physical, emotional, and behavioural symptoms that usually occurs a week or two before the menses.
The physical symptoms of PMS may include breast tenderness, bloating or heaviness in the abdomen, headache, constipation or diarrhea, acne, and muscle pains, while the emotional symptoms may present in the form of restlessness, anxiety, anger, irritability, cravings and mood swings.
While a combination of many factors like hormonal changes, chemical changes in the brain and lifestyle factors are considered to cause PMS, some factors that can increase the risk of PMS symptoms include being overweight or obese, smoking, personal or family history of depression or certain nutritional deficiency of vitamins and minerals.
Dr Aman Aditya Pandey Says
Lifestyle adjustments can help you reduce or manage the signs and symptoms of PMS. The conservative approaches such as exercise, yoga, and meditation, help in alleviating depressive symptoms. Also, your doctor can help you find ways to relieve your symptoms with the help of certain drugs.
Key Facts
Usually seen in
- Women between 20 to 30 years of age
Gender affected
- Women
Body part(s) involved
- Uterus
Prevalence
- Worldwide: 47.8% (2020)
Mimicking Conditions
- Depression
- Anxiety
- Perimenopause
- Chronic fatigue syndrome
- Irritable bowel syndrome (IBS)
- Thyroid disease
Necessary health tests/imaging
- Pelvic exam test
- Patient record
Treatment
- Painkillers: Ibuprofen, Naproxen & Aspirin
- Antidepressants: Fluoxetine, Sertraline, Paroxetine & Escitalopram
- Birth control pills (oral contraceptives): Drospirenone & Ethinyl estradiol
- Gonadotropin-releasing hormone (GnRh) agonists: Leuprolide & Goserelin acetate
- Diuretics: Spironolactone
Specialists to consult
- General physician
- Gynecologist
- Psychiatrist
- Counselor
Symptoms Of PMS
There are various physical and emotional symptoms associated with PMS. They can also vary from month to month and are sometimes so severe that they affect the daily lives of women. Symptoms usually peak two days before menstruation and disappear within four days of menstruation. Symptoms might include:
Physical symptoms
- Change in appetite
- Weight gain
- Back pain
- Headache
- Swelling and tenderness of breasts
- Constipation
- Tiredness
- Pain in the genital area (dyspareunia)
- Nausea
- Diarrhea
- Bloating
- Migraine
- Drowsiness
- Poor concentration
- Insomnia
- Increased nap-taking
- Swelling of the hands and feet
- Bodyache
- Joint pain
- Lower tolerance for noise or light
- Abdominal pain
- Menstrual cramps
Worried about what’s to come after PMS? Here are 6 effective ways to manage period pain. Emotional symptoms
Crying
Mood swings
Irritability
Anger
Feelings of tension
Disinterest in daily activities
Fatigue
Feeling overwhelmed or out of control
In some women with PMS, severe, debilitating symptoms occur which can affect the daily routine activities of women, known as premenstrual dysphoric disorder (PMDD). It causes extreme mood shifts such as:
Severe depression
Panic attacks
Feelings of hopelessness
Low self-esteem
Anger and irritability
Crying spells
Suicidal thoughts
Did you know?
Symptoms of PMS are very similar to the symptoms of early pregnancy. Listen to our experts explain PMS better.
Causes Of PMS
The exact cause of PMS is not known. The hormone fluctuations may play a role in developing symptoms of PMS. Some women react more to these fluctuations than others, which can be linked to genetic factors or chemicals released in the brain. The following changes in the hormones that may cause PMS include:
1. Estrogen
The fluctuations in estrogen levels cause mood swings. Studies also suggest that a decreased amount of estrogen stimulates common symptoms of PMS such as insomnia, fatigue, and depression.
2. Progesterone
PMS is also influenced by the hormone progesterone. Low progesterone levels or progesterone levels falling too rapidly during the second half of the menstrual cycle can lead to PMS symptoms.
3. Serotonin
There is an increase in serotonin precursors between days 7 to 11 and 17 to 19 of the menstrual cycle. This rise in serotonin causes mood swings which is a significant symptom of PMS.
4. Prolactin
Women with PMS symptoms have high levels of prolactin, especially in the premenstrual time. Studies suggest that high prolactin levels clubbed with low levels of progesterone can lead to anxiety and depression.
Most of the women have a lot of questions about periods. And one of the most common ones is: Are my periods normal? Have a question about periods?
Risk Factors Of PMS
Though the exact cause of PMS is still unknown, there are an array of risk factors that are associated with PMS. They include:
1. Age
PMS is a disease that is linked with menstrual cycles, so it affects women after menarche (the first occurrence of menstruation) till menopause. It is mostly seen between mid 20s to late 30s.
There are several changes in the woman’s body as she turns 30. So let’s explore what 30s hav2. Lifestyle factors
There are various lifestyle factors that can increase the chances of PMS.
Diet: Excess intake of sugar, coffee, packaged and processed food is associated with an increased risk of PMS.
Sedentary lifestyle: Some studies also suggest the role of sedentary and inactive lifestyles in PMS.
Poor sleep quality: Inadequate and poor quality sleep predisposes women to PMS.
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