Premenstrual syndrome (PMS)

PMS adversely impacts a woman’s emotional and physical wellbeing before her menstrual cycle. 

A woman with PMS lying on a couch with a hot water bottleMost women experience normal premenstrual symptoms such as breast tenderness or cramps a few days before their periods start. However, it is only when these symptoms disrupt a woman’s daily functioning and life that it becomes known as premenstrual syndrome (PMS). 

PMS occurs a week or even two before your period starts. The symptoms usually go away after you start bleeding. They also go away when you get pregnant or go through menopause. However, symptoms can vary from month to month and be mild to strong. 

A small percentage of women have symptoms that are severe and disable their daily functioning. This is the result of a more intense – but rare – type of PMS known as premenstrual dysphoric disorder (PMDD). 

PMS causes are not completely clear, but there are several factors involved. These include changes in hormones during the menstrual cycle, chemical changes in the brain, and stress and emotional factors. Other possible causes include:

  • Low levels of vitamins and minerals
  • Salty foods, which cause fluid retention 
  • Alcohol and caffeine, which alters mood and energy levels

PMS can strike women in their teens or later in their lives. It isn’t known why PMS affects some women and not others, although it has been established that PMS is hereditary. 

What are its symptoms?

PMS can affect women of any age and the effect is different for each woman.

It can include physical and emotional symptoms, such as:

  • Acne
  • Cramps
  • Swollen or tender breasts
  • Abdominal pain
  • Breast pain
  • Tiredness
  • Sleep problems
  • Back pain
  • Weight gain
  • Upset stomach, bloating, constipation
  • Headache
  • Appetite changes and/or food cravings
  • Joint or muscle pain
  • Trouble with concentration 
  • Mood swings
  • Anxiety or depression

PMDD symptoms may include:

  • Feelings of hopelessness
  • Sadness or depression
  • Anger and anxiety
  • Sleeping much more or less than usual
  • Low self-esteem
  • Tension and irritability

How is it diagnosed? 

A typical diagnosis starts with a visit to your doctor or gynaecologist. He/she may ask you to keep notes or a diary of your symptoms for at least two menstrual cycles. Note the day that you first notice PMS symptoms, as well as the day they disappear. Also, mark the days your period starts and ends. 

A PMS diagnosis can be difficult because many medical and psychological conditions mimic symptoms. There are no blood or laboratory tests for PMS but laboratory tests are used to exclude conditions that mimic PMS.

These conditions include:

What are your treatment options? 

There is no cure for PMS but there are treatments that can help you manage its symptoms. If your PMS is mild or moderate, you can make changes to your lifestyle and diet. 

Lifestyle changes include:

  • Regular exercise
  • Limited salt intake 
  • Limited caffeine intake 
  • Stop smoking
  • Reduce sugar intake

Some studies show that calcium and magnesium supplements may also provide relief.

Your doctor may prescribe one or more medications for PMS. The success of medications in relieving symptoms varies.

These include:

  • Antidepressants for mood symptoms
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for cramping and breast discomfort
  • Diuretics to help your body shed excess fluid
  • Hormonal contraceptives to stop ovulation, which may offer relief from PMS symptoms

Can it be prevented? 

While there is no cure for PMS, the symptoms can be successfully managed with lifestyle changes, dietary changes, supplements, hormone treatments, medications and other remedies. You may have to experiment to find the balance of treatments that works best for you.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016