What is premenstrual syndrome (PMS)?

‍Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms that can occur in the week before your period like: mood swings, irritability, anxiety, tender breasts, bloating, fatigue, … These symptoms can be intense and have an impact on your daily routine. The causes of PMS are still unknown and still being researched, however, by understanding your own body and keeping track of your symptoms you can find ways to reduce the severity. 

Symptoms

It's important to remember that every woman's experience with premenstrual syndrome (PMS) is unique and symptoms can vary greatly in intensity. Here is a list of some common symptoms:

The most common emotional symptoms are:

• mood swings
• irritability
• anxiety
• depressed feelings
• difficulty concentrating

The most common physical symptoms are:

• tender breasts
• bloating
• fatigue
• headache
• joint or muscle pain
• cravings for sweet or carbohydrate-rich foods (e.g. chocolate, grain products, etc.)

PMS & your menstrual cycle

The beginning of a new menstrual cycle is marked by the start of your period, referred to as the first day of your cycle. A typical menstrual cycle lasts an average of 28 days, but a range between 25 to 35 days is considered normal. It's important to note that every cycle can be unique and may vary in duration. As you approach the end of your menstrual cycle, it's common to experience more premenstrual syndrome (PMS) symptoms. This typically happens in the period leading up to your period.

You deserve care!

Although PMS is common among women, it's not a normal part of being a woman. PMS symptoms are signals from your body, both mental and physical, that something is off and needs attention. Remember, you deserve care and it's important to take steps to manage your symptoms and to give yourself the support you need.

For some women, the symptoms of PMS can be severe and significantly impact their daily lives. In such cases, it could be a more severe form called PMDD, a condition where the brain is highly sensitive to the hormonal fluctuations of estrogen and progesterone. Remember there are ways to manage and alleviate PMS symptoms, and it's okay to seek help if you feel overwhelmed by the symptoms.

Causes

Unfortunately, there is little research on premenstrual symptoms, so scientists do not yet know the exact cause of PMS. There are many theories about what may cause PMS, and these include:

• too little or too much estrogen or progesterone
• sensitivity to progesterone
• sensitivity of the brain to natural hormone fluctuations

Treatment

Since there is little scientific research on PMS, there is no one-size-fits-all treatment. Different treatments can have varying effects from woman to woman, so it is important to find what works for you. Your doctor may recommend exercising, cognitive behavioral therapy, and/or taking vitamin B6 as a first step.

If these measures are not enough, your doctor may suggest hormone treatment, such as estradiol patches. SSRIs, a type of antidepressant, may also provide relief. 

Conclusion

It is common for many women to experience premenstrual syndrome. Unfortunately, there is still much unknown about the exact causes of PMS and there is not a one-size-fits-all solution. However, there are some treatment options that may be able to alleviate your symptoms. Don't hesitate to speak with your primary care doctor or gynecologist if you think you may have PMS.

‍

Sources:

Freeman, Ellen W. “Premenstrual Syndrome and Premenstrual Dysphoric Disorder: Definitions and Diagnosis.” Psychoneuroendocrinology, vol. 28, no. 3, 2003, pp. 25–37.

Green LJ, O’Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome. BJOG 2017;124:e73–e105.

Maharaj S, Trevino K. A Comprehensive Review of Treatment Options for Premenstrual Syndrome and Premenstrual Dysphoric Disorder. J Psychiatr Pract. 2015 Sep;21(5):334-50. doi: 10.1097/PRA.0000000000000099. PMID: 26352222.