Premenstrual Syndrome
Premenstrual Syndrome
Premenstrual syndrome (PMS) refers to a range of physical and emotional symptoms that occur cyclically before menstruation. Symptoms typically begin one to two weeks before a menstrual period and gradually resolve after it starts. Although symptoms usually last for only one to two weeks, severe cases can affect a person’s daily activities, work and relationships.
Symptoms of Premenstrual Syndrome
Physical symptoms: Fluid retention, breast tenderness, insomnia and changes in appetite
Emotional symptoms: Mood swings, low mood, anxiety and irritability
Approximately 20% to 30% of women with premenstrual symptoms experience difficulties that affect their work or relationships. Around 3% to 8% experience more severe emotional symptoms, a condition known as premenstrual dysphoric disorder (PMDD).
Causes of Premenstrual Syndrome
The exact cause of premenstrual syndrome (PMS) is not yet fully understood. Two main explanations have been proposed. One suggests that hormonal changes around menstruation trigger physical and psychological responses. The other suggests that changes in neurotransmitters in the brain, such as serotonin and dopamine, may contribute to mood fluctuations.
Treatment for Premenstrual Syndrome
Treatment depends mainly on the severity of the symptoms. Lifestyle changes may be tried first. If symptoms do not improve or begin to significantly affect daily life, medication or psychological therapy may be considered.
1. Lifestyle Changes
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Dietary adjustments: Reducing caffeine and alcohol intake may help relieve symptoms. Limiting foods high in sugar and salt may also help reduce fluid retention.
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Keep a symptom diary: Recording symptoms can help identify when they are likely to begin and subside. Understanding this pattern may also provide reassurance and assist with treatment planning.
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Maintain a healthy routine: Regular sleep and adequate rest are important. Planning relaxing activities before menstruation and finding ways to manage stress at home and at work may help reduce symptoms.
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Exercise regularly: Regular physical activity can support overall physical and emotional well-being and may help relieve premenstrual discomfort.
2. Medication
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Antidepressants or anti-anxiety medications may be considered for patients experiencing severe emotional symptoms. Hormonal treatments, such as oral contraceptives or progesterone-based medication, may also be prescribed to suppress ovulation and relieve physical symptoms. The choice of medication should be based on an individual medical assessment.
Reference
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Freeman, E. W. (2003). Premenstrual syndrome and premenstrual dysphoric disorder: definitions and diagnosis. Psychoneuroendocrinology, 28, 25-37.
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Halbreich, U., Borenstein, J., Pearlstein, T., & Kahn, L. S. (2003). The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology, 28, 1-23.
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Rapkin, A. (2003). A review of treatment of premenstrual syndrome & premenstrual dysphoric disorder. Psychoneuroendocrinology, 28, 39-53.
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Pearlstein, T., & Steiner, M. (2012). Premenstrual dysphoric disorder: burden of illness and treatment update. Focus, 10(1), 90-101.