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Last Updated on December 18th, 2020
You might be getting some signs, such as tender breasts or craving for sweet, which indicate that periods are near. While these symptoms might not be a deal for some women, for others these days before menses are harder. If they restrict with your daily activities, you may have premenstrual syndrome.
Premenstrual syndrome or PMS is a condition that alters a woman’s physical health, emotions, and behavior during certain days of the monthly menstrual cycle, usually before periods.
It is a common condition, affecting almost three out of every four menstruating women.
Symptoms of PMS, such as irritable mood and tender breasts, return predictably. However, the intensity of physical and emotional symptoms may vary for everyone.
The good news is that the symptoms are manageable. Lifestyle adjustment and treatment can help in managing premenstrual syndrome.
Let’s understand more about it.
What is Premenstrual Syndrome?
PMS is a set of signs and symptoms that impair some aspects of your life. It starts somewhere between five to 11 days before menses and settles with the onset of menstruation.
The cause of PMS is unknown, researchers believe that it is associated with serotonin and sex hormone levels during the initial phase of the menstrual cycle.
Levels of sex hormones estrogen and progesterone are higher during certain days of the month. An increase in these hormones is associated with anxiety, mood swings, and irritability. Further, ovarian steroids can also alter activity in the brain area associated with PMS.
Serotonin, a chemical in your brain, also affects your emotions, moods, and thoughts.
Now that you know about PMS, let’s have a look at its causes.
Cause of PMS
- Chemical changes: Fluctuation of serotonin levels results in fatigue, sleep problems, premenstrual depression, and food cravings.
- Cyclic hormonal changes: The signs and symptoms of PMS depend on fluctuation and settle by menopause and pregnancy.
- Depression: It is seen that some women with PMS suffer from undiagnosed depression. However, depression alone cannot cause all symptoms related to premenstrual syndrome.
Some conditions affect PMS but do not cause them, such as:
- Lack of sleep
- Sedentary lifestyle
- Excess alcohol consumption
- Increased consumption of red meat, salt, or sugar
Risk Factors for PMS
Many factors increase the risk of PMS. Some of them are:
- A family history of premenstrual syndrome
- Domestic violence
- Physical and/or emotional trauma
- Substance abuse
- A family history of depression
- Family history of mood disorders or depression
PMS is also seen to be associated with certain conditions, such as:
- Major depressive disorder
- Generalized anxiety disorder
- Seasonal affective disorder
Signs and Symptoms of PMS
Usually, a menstrual cycle lasts for 28 days. Ovulation, the release of an egg from the ovaries, takes place on the 14th day of the menstrual cycle and bleeding occurs on the 28th day.
Premenstrual syndrome symptoms start around the 14th day and can last up to a week after the start of the cycle.
It is seen that almost 80% of women have PMS symptoms that do not major affect their daily functioning.
While 32% of women face moderate to severe PMS symptoms that alter some aspect of their life, only three to eight percent of women have severe PMS, known as premenstrual dysphoric disorder (Find more about it below).
Some symptoms include:
- Abdominal bloating
- Sore breasts
- Food cravings
- Sensitivity to sound or light
- Abdominal pain
- Sleep pattern fluctuations
- Emotional outburst
- Muscle or joint pain
- Change in libido
- Social withdrawal
- Alcohol intolerance
Premenstrual Dysphoric Disorder (PMDD)
It is a severe form of PMS and is extremely rare, affecting only three to eight of menstruating women.
Some symptoms of PMDD are:
- Suicidal thoughts
- Extreme anxiety
- Crying spells
- A lack of interest in day-to-day activities
- Binge eating
- Panic attack
- Severe mood swings
- Poor concentration
The symptoms of PMDD depend on the change in progesterone and estrogen levels. They are also linked to low serotonin levels.
Diagnosis of PMS
There are no specific tests to diagnose premenstrual syndrome. Your doctor will diagnose it in the presence of a set of symptoms, and if they occur is a predictable fashion at a certain stage of the menstrual cycle.
To find out the pattern, the doctor may ask you to record signs and symptoms in a diary or a calendar for at least two period cycles. You can note the date when you first notice PMS symptoms and also the date they disappear. You will also need to mark the start and end of your menstrual cycle.
Various disorders, such as thyroid diseases and chronic fatigue syndrome, can mimic PMS. Besides, mood disorders such as anxiety and depression also have similar symptoms. Your doctor might advise some investigations and mood screening tests to confirm the diagnosis.
Criteria for PMS are:
- PMS symptoms that begin five days before your menses and subsides by four days.
- Symptoms are present for at least two to three months
- Symptoms interfere with your daily activities
How Can You Manage It?
While PMS can affect your daily routine, there are many ways to manage it. The ideal treatment option depends on your symptoms.
Treatment options include:
You can try prescription or OTC medications to manage PMS symptoms.
- Pain relievers: They can help to manage cramps, muscle pain, and headaches.
- Diuretics: Also known as water pills, they help the body to get rid of excess water through urine. Diuretics aid in managing swelling and bloating associated with PMS.
- Nonsteroidal anti-inflammatory drugs: They help in managing breast soreness and abdominal cramps.
- Contraceptives: They prevent ovulation and thus relieve premenstrual syndrome symptoms.
Exercise can improve progesterone and estrogen levels, reducing premenstrual symptoms.
It is seen that doing 1.5 hours of exercise in a week helps in managing the following PMS symptoms:
- Constipation and diarrhea
- Increased appetite
- Swelling of breasts
Using relaxation techniques can help to manage emotional symptoms of PMS
Some relaxation techniques involve:
- Tai chi
- Taking a bath
- Talking to a close friend
You can try the following:
- Avoid salt and salty food to prevent water retention and bloating.
- Take frequent and smaller meals.
- Avoid alcohol and caffeine.
- Include food rich in complex carbohydrates such as vegetables, fruits, and whole grains.
- Have calcium-rich foods
Add Certain Nutrients
- Fatty acids: Some sources include nuts, fish, and green vegetables. Fatty acids are seen to relieve menstrual cramps.
- Magnesium: It is present in leafy vegetables such as spinach and kale. Magnesium aids in relieving migraine episodes associated with PMS.
- Calcium: It is seen that calcium intake improves anxiety, depression, and water retention. It also aids in regulating sleep, mood, and food cravings.
You can also use the following supplements are seen to manage PMS symptoms:
- Vitamin B6
- Folic acid
- Vitamin D
You can also try the following:
- Stay hydrated and take enough fluids
- Get adequate sleep
- Reading a book or pursuing hobbies to relieve stress
- Try cognitive behavioral therapy
Frequently Asked Questions
How can I confirm that I have PMS?
To confirm the diagnosis of PMS, your doctor will confirm if there is a pattern of symptoms. Usually, the symptoms are:
- Present five days before the menstrual cycle and are present for at least three cycles.
- Interferes with your ability to perform daily activities.
- End within four days of the menstrual cycle.
To help your doctor diagnose this condition, you can maintain a record of the symptoms with date in a diary. Record your menstrual cycle dates as well.
Can PMS affect other conditions?
Yes, PMS can affect certain disorders, such as anxiety and depression. Other disorders, such as migraine, asthma, and seizure, can also get worse during your menstrual cycle.
Is PMS treatable?
Yes, for sure. In case your symptoms are mild to moderate, it can be managed through dietary and lifestyle modifications. However, if the symptoms are intense and interfere with your daily activities, your doctor might prescribe medications to manage them.
Premenstrual syndrome includes physical and emotional symptoms occurring at a specific time of the menstrual cycle.
It is a common condition with most women experiencing at least one symptom of PMS. While the exact cause is not known, hormonal imbalance and chemical changes in the brain are seen to play an important role.
The severity can be mild to severe. Only a small percentage of menstruating women have a severe form of PMS known as PMDD.
But the best part is various treatment options, such as medications, managing stress, and dietary changes that can help in managing PMS symptoms.
It is recommended to consult a physician if the symptoms do not improve or worsen despite treatment or interfere with your daily activities.
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