Premenstrual Syndrome (PMS)

What is premenstrual syndrome?

The symptoms experience by woman before the onset of periods can be classified under premenstrual syndrome (PMS). There are a number of symptoms evident such as mood swings, food cravings, breast pain, irritability and depression and fatigue. Most women experience some kind of premenstrual syndrome, though it may not be much severe in many. The symptoms are more prominent in their 20s. The severity of symptoms may vary and may not be the same every month. Emotional distress can lead to anxiety and physical symptoms may impair a person’s daily routine.

What are the symptoms of PMS?

Both physical and psychological symptoms are seen in PMS.

Psychological symptoms

  • Depression.
  • Anxiety.
  • Irritability or mood swing.
  • Crying spells.
  • Change in appetite.
  • Lack of concentration and social withdrawal.
  • Insomnia.

Physical symptoms

  • Weight gain.
  • Fatigue.
  • Pain in the breasts.
  • Bloating.
  • Diarrhea or constipation.
  • Flare up of acne.

All symptoms are not present in every woman. The symptoms usually subside on the onset of menses. When severe symptoms are present it is known as premenstrual dysphoric disorder (PMDD) where symptoms are severely disabling such as severe depression and excessive fatigue.

What causes premenstrual syndrome?

The exact cause of premenstrual syndrome is not known, though several factors are found to play a significant part in bringing about the condition:

  • Hormonal changes: All women go through a cyclic change of hormones with certain hormonal prevalence in the earlier part of the month and some in the latter. The symptoms of premenstrual syndrome are seen during the reproductive period of a woman’s life and disappear as the menses cease with contraceptive use or pregnancy or at menopause.
  • Changes in the brain chemicals: A brain chemical called serotonin influences mood state of a person. An increase or decrease in serotonin could initiate symptoms of premenstrual syndrome.
  • Psychological stress: Symptoms can be aggravated by stress.
  • Nutritional status: Malnutrition and low vitamin consumption may influence premenstrual syndrome. Eating excessive salty foods, alcohol and caffeine may induce symptoms of PMS.

How is premenstrual syndrome treated?

Premenstrual syndrome (PMS) should be managed conservatively through diet, stress management and other measures. Some medication are found to help relieve the symptoms me PMS though the benefit from these medications varies from person to person.

  • Antidepressant medication affects serotonin, the brain chemical, called as SSRIs or selective serotonin reuptake inhibitors help reduce the symptoms. These include drugs like paroxetine, fluoxetine and sertraline. The drugs help reduce fatigue and sleep problems. These drugs may need to be taken daily or a few days before the onset of menstruation.
  • NSAIDS or nonsteroidal antiinflammatory drugs such as ibuprofen or naproxen can help in symptoms of breast discomfort or cramping.
  • Diuretics along with reduced salt intake can help relieve swelling and bloating and weight gain. Spironolactone which is a diuretic can help relieve symptoms of PMS.
  • Hormonal fluctuations during menses can be prevented with the use of oral contraceptive medications. Certain drugs such as medroxyprogesterone can stop ovulation but other symptoms such as increased appetite and weight gain may develop with its use.
  • Calcium and magnesium supplementation along with the intake of vitamin B6 and vitamin E may help symptoms to some extent.

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