As the name suggests, Pre means “before,” and menstrual means “menses.” Premenstrual syndrome ( PMS) is the most common syndrome that occurs in the reproductive phase of all women. According to epidemiological studies, it is noted that about 80 to 90 % of women present with one of the PMS Signs. On the other hand, only 2 to 3% of women are affected severely due to PMS. This condition is known as premenstrual dysphoric disorder ( PMDD). The prevalence of PMS worldwide is about 4.78 %.
Contents
What is PMS?
The premenstrual syndrome manifests cyclical somatic, psychological, and emotional symptoms that every woman experiences in her luteal ( reproductive ) phase and is resolved when menstruation ceases.
What is premenstrual dysphoric disorder?
It is the most severe form of the disease, considered a psychiatric disorder. It causes extreme mood swings that affect the daily life routine.
What are the causes of PMS?
The exact cause of PMS is still uncertain, but it is believed that it occurs due to hormonal fluctuations like estrogen (increased levels) and progesterone (decreased levels). This disproportion leads to PMS symptoms. PMS is also caused by serotonin.
What are the risk factors?
- Stress/anxiety
- Positive family history of depression
- History of postpartum depression
- Alcohol drinking
What are the signs and symptoms of PMS?
Symptoms of premenstrual syndrome are different for every woman. Symptoms can be physical or emotional.
Physical symptoms
- Bloating
- Nausea
- Cyclical weight gain
- Mastalgia (Breast pain or tenderness)
- Fatigue
- Abdominal cramps
- Headache
- Muscle pain
- Acne
- Diarrhea or constipation
- Back pain / low back pain
- Emotional symptoms:
- Depression
- Anxiety
- Depressed mood
- Crying spells
- Insomnia
Social withdrawal
- Less libido
- Irritability
- Mood swings/anger
- Decreased concentration
- Appetite changes
- Restlessness
How is Premenstrual syndrome diagnosed?
PMS diagnosis is symptomatic. Your doctor will ask you about the following:
- Symptoms
- Onset and duration
- When do you get it resolved?
- Does it affect your normal life routine?
An initial workout is done to rule out the other pathologies like thyroid disease, Cushing disease, and hyperprolactinemia by investigating FSH levels, TSH levels, prolactin levels, cortisol levels, and estradiol levels in the blood.
What is the treatment of PMS?
Treatment criteria of PMS depend upon the severity of the disease.
1. Mild to moderate PMS
Non Pharmacological therapy:
Non Pharmacological therapy is the treatment of choice for mild to moderate PMS.
A healthier lifestyle, regular exercise, and a healthy nutrition diet plan.
Stress management:
- Relaxation
- Yoga
- Breathing techniques
- Contemplation and thinking
Counselling:
- Family
- Friends
- Professional counsellor
Complementary therapy:
- Vitex Agnus castus 20-40mg/day
- Red clover isoflavones 40-80 mg/day
Vitamins and minerals :
- Vitamin B6 50 mg/day with GP supervision
- Magnesium 250 mg /day
2. Moderate to severe PMS
and behavioral approaches treat moderate to severe forms of PMS. Selective serotonin reuptake inhibitors ( SSRI) are the first-line therapy for the premenstrual disorder.
- COCP (Combined oral contraceptives)
- GnRH analogues
- Cognitive-behavioural therapy
- Light therapy
- Chiropractic therapy
Surgical treatment
It is the treatment of choice in severely affected women when symptoms are not relieved by medication or any other therapy.
Bilateral oophorectomy is a very effective surgical procedure to reduce PMS symptoms. Hysterectomy is not the treatment of choice and is not recommended in young women.
