Symptoms of Premenstrual Syndrome (PMS)

Premenstrual syndrome is an issue of concern to women who have not attained menopause. Most people don’t like to talk about their period. But it is very important for young girls, parents and teachers to bring up such discussions. This is because there are many young girls and even adult women who encounter certain physical and emotional changes during their period. Some don’t understand these changes and so find that time of the month very difficult to cope with and adjust. Needless to mention practicing good menstrual hygiene.

In this article, we will look at some of those symptoms that you may experience usually in the final week just before you start menstruating. These symptoms have been categorized as a condition known as premenstrual syndrome (PMS). Understanding these symptoms will help you know what to do and how to adjust during that time of the month.

What is PMS?

This is defined as the cyclic occurrence of symptoms you have just before your period begins. These symptoms are of sufficient severity to interfere with some aspects of your daily activities. PMS appear to have a consistent and predictable relationship with the luteal phase of the menstrual cycle.

No single, easily understood cause for PMS has been found yet. Certain patterns however, have been shown to contribute to the cause of this syndrome in women.

A variety of hormonal changes have been identified in patients with PMS, particularly an increase in the estrogen to progesterone ratio. Abnormalities in thyroid function, as well as in the production of prolactin (milk producing hormone) have also been identified as a contributory cause for PMS in women. Many patients have also been found to show vitamin B6 deficiency as a causative factor.

How to tell if you are suffering from PMS

PMS is a very common experience for women of childbearing age. Up to 85% of menstruating women report one or more premenstrual syndrome symptoms. But only about 5% – 10% have symptoms severe enough to to interfere with aspects of their life. Symptoms occur during the last week of the luteal phase of the menstrual cycle and remits a few days after the onset of menstruation.

The typical symptoms of PMS during menstruation  include

Some women may suffer from a similar condition called Premenstrual Dysmorphic Disorder (PMDD). The difference between this disorder and PMS is in the severity of the emotional symptoms. Typically, emotional symptoms dominate over the physical symptoms in premenstrual dysmorphic disorder. These symptoms include :

Seeing A Doctor

You may need to see your doctor if your symptoms are becoming unbearable. Diagnosis is based on history taking of symptoms. Women are advised to keep a “symptom dairy” noting the severity and timing of symptoms in relation to menstruation periods. This makes history taking by the doctor more reliable. Factors the doctor will consider when diagnosing PMS or premenstrual dysmorphic disorder are :

  1. Symptoms must be severe enough to markedly interfere with your work, school, usual social activities and relationship with others.
  2. You have no other disorders that can cause similar symptoms. Lab investigations like full blood count, liver function test, kidney function test, lipid profile, thyroid function test, serum estrogen, progesterone, FSH, LH and prolactin test will be done to rule out other causes.
  3. The symptoms you are having must be present during at least 2 consecutive menstrual cycles.

Treating Your Symptoms

Symptoms of premenstrual syndrome and premenstrual dysmorphic disorder can be treated.  Selective Serotonin Re-uptake Inhibitors (SSRIs) are the treatment of choice for severe forms of these conditions.

Oral contraceptive can be used to suppress ovulation. This may improve physical symptoms of PMS but not the emotional symptoms. Diuretics are also indicated for women with significant fluid retention, bloating and edema.

Reducing your intake of caffeine, salt and alcohol will help resolve your symptoms. You should increase your consumption of  complex carbohydrate diet when your period is about to begin. This has been shown to be helpful in treating mild to moderate PMS symptoms.

Calcium carbonate, vitamin B6 and magnesium have also been found to be helpful in reducing PMS symptoms. Discuss with your doctor about which of the treatments will best suit you.

 

References

  • A. K. Ghosh et al (2008), “women’s health ” Mayo clinic Internal medicine Review , 8th edition (pg 1059).
  • Mayoclinic :  premenstrual syndrome

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